{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:19:22Z","timestamp":1790806762234,"version":"4.1.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study Objectives<\/jats:title>\n                    <jats:p>To describe the phenotype of narcolepsy with intermediate cerebrospinal fluid hypocretin-1 levels (CSF hcrt-1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 1600 consecutive patients with narcolepsy from Bologna and Montpellier sleep centers, we selected patients with intermediate CSF hcrt-1 levels (110\u2013200 pg\/mL). Clinical, neurophysiological, and biological data were contrasted for the presence of cataplexy, human leukocyte haplotype (HLA)-DQB1*06:02, and median CSF hcrt-1 levels (149.34 pg\/mL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-five (55% males, aged 35 \u00b1 17 years) patients (2.8% of all cases) were included. Thirty-three (73%) were HLA-DQB1*06:02, 29 (64%) reported cataplexy (21, 72.4% with typical features), and 5 (11%) had presumed secondary etiology. Cataplexy was associated with other core narcolepsy symptoms, increased sleep onset rapid eye movement periods, and nocturnal sleep disruption. Cataplexy and irrepressible daytime sleep were more frequent in HLA-DQB1*06:02 positive patients. Lower CSF hcrt-1 levels were associated with hallucinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Narcolepsy with intermediate CSF hcrt-1 level is a rare condition with heterogeneous phenotype. HLA-DQB1*06:02 and lower CSF hcrt-1 were associated with typical narcolepsy features, calling for future research to distinguish incomplete from secondary narcolepsy forms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsab285","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T09:59:06Z","timestamp":1639389546000},"source":"Crossref","is-referenced-by-count":36,"title":["Narcolepsy with intermediate cerebrospinal level of hypocretin-1"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2058-2047","authenticated-orcid":false,"given":"Emanuela","family":"Postiglione","sequence":"first","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna , Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Barateau","sequence":"additional","affiliation":[{"name":"Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center , Montpellier , France"},{"name":"National Reference Network for Narcolepsy, Gui-de-Chauliac Hospital, University Hospital Center , Montpellier , France"},{"name":"Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pizza","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna , Bologna , Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna , Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8591-0553","authenticated-orcid":false,"given":"R\u00e9gis","family":"Lopez","sequence":"additional","affiliation":[{"name":"Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center , Montpellier , France"},{"name":"National Reference Network for Narcolepsy, Gui-de-Chauliac Hospital, University Hospital Center , Montpellier , France"},{"name":"Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Antelmi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona , Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Laura","family":"Rassu","sequence":"additional","affiliation":[{"name":"Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Vandi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna , Bologna , Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna , Bologna , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9545-4958","authenticated-orcid":false,"given":"Sofiene","family":"Chenini","sequence":"additional","affiliation":[{"name":"Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center , Montpellier , France"},{"name":"National Reference Network for Narcolepsy, Gui-de-Chauliac Hospital, University Hospital Center , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Mignot","sequence":"additional","affiliation":[{"name":"Center for Sleep Sciences and Medicine, Stanford University Medical School , Palo Alto, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Dauvilliers","sequence":"additional","affiliation":[{"name":"Sleep-Wake Disorders Center, Department of 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