205 Attention Regulation in Narcolepsy Type 1 Figure 2. Behavioural results. (A-B) show the performance over the entire task per group. (C-D) show the time-on-task performance over repetitions (repetition 1 vs. repetition 4). (E-F) show the time-on-task performance within blocks (early half vs. late half). Significant differences (p < 0.05) are highlighted with an asterisk (*) and significant differences in black represent all subjects combined. Main task effect The “task > baseline” contrast elicited significantly stronger BOLD activation in the cingulo-opercular network, arousal system, motor (regulatory) areas, and visual cortex (Figure 3 and Table 2). The cingulo-opercular network was activated by means of the bilateral insula, thalamus, anterior cingulate cortex, and the right middle frontal gyrus. Other attention-regulation-related areas included the bilateral midcingulate cortex, right intraparietal sulcus and left inferior parietal gyrus being part of the frontoparietal network, vermis and bilateral inferior orbitofrontal gyrus, and fusiform gyrus. Motor (control) areas comprised the left pre- and postcentral gyrus, bilateral supplementary motor area, putamen, and cerebellum. The bilateral red nucleus, substantia nigra, and locus coeruleus within the midbrain and pons were also activated, with the pons being fundamental in managing arousal and attention. Task activation patterns of healthy controls and people with narcolepsy type 1 were similar and no significant main task effect differences were present between groups. No significant group differences were seen on the “baseline > task” and “higher difficulty level > moderate difficulty level” contrasts. 7
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