29 Introduction Table 1. Continued. Study Neuroimaging technique Disorder Sample size (number of females) Mean age, years (SD) Diagnosis * Medicated: unmedicated Main findings in patients (compared to controls) Patients Controls Patients Controls Gao et al. 2024 EEG + fMRS (3T) NT1 26 (12) 29 (16) 23.0 (1.9) 23.8 (1.5) PSG, MSLT, cataplexy 0:26 Increased GABA/Glutamate-Glutamine ratio and GABA concentration in the prefrontal lobe in NT1. VBM highlights structures in the brain that have different volume by transforming the brain scan of each patient into the same standard template space. Manual tracing involves human experts to outline structures in the brain on MRI scans. Automated segmentation is similar to manual tracing except the tracing is performed by a computer algorithm. DWI is a specific scanning protocol designed to extract information about the orientation and integrity of white matter tracts in the brain. * Tests that were used to verify the hypersomnolence diagnosis of the included patients; ** Subjects withdrew from medication for a period prior to the start of the study. *** median and interquartile range. † NT1 and NT2 subjects were grouped together. DWI = Diffusion-weighted imaging; DTI-ALPS = Diffusion tensor image analysis along the perivascular space; EEG = Electroencephalography; fMRS = Functional magnetic resonance spectroscopy; GM = Grey matter; HLA = Human leukocyte antigen; IH = Idiopathic hypersomnia; MRS = Magnetic resonance spectroscopy; NR = Not reported; NT1 = Narcolepsy type 1; NT2 = Narcolepsy type 2; T = Tesla (strength of MRI magnet); VBM = Voxel Based Morphometry; WM = White matter. 1
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