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Unfortunately, research on cognition in narcolepsy has been limited. Strong evidence demonstrates difficulties with sustained attention, but evidence for executive dysfunction and impaired memory is mixed. Animal research provides some insights into how loss of the orexin neurons in narcolepsy type 1 may give rise to impaired cognition via dysfunction of the prefrontal cortex, and cholinergic and monoaminergic systems. This paper reviews some of these clinical and preclinical findings, provides a neurobiological framework to understand these deficits, and highlights some of the many key unanswered questions.<\/jats:p>","DOI":"10.1093\/sleep\/zsae150","type":"journal-article","created":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T06:10:26Z","timestamp":1719641426000},"source":"Crossref","is-referenced-by-count":24,"title":["Impaired cognition in narcolepsy: clinical and neurobiological perspectives"],"prefix":"10.1093","volume":"47","author":[{"given":"Christopher A","family":"Cano","sequence":"first","affiliation":[{"name":"Department of Neurology, Beth Israel Deaconess Medical Center , Boston, MA,","place":["USA"]},{"name":"Department of Neurology, Brigham and Women\u2019s Hospital , Boston, MA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T","family":"Harel","sequence":"additional","affiliation":[{"name":"Neuroscience Therapeutic Area Unit, Takeda Development Center Americas Inc. , Cambridge, MA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E","family":"Scammell","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beth Israel Deaconess Medical Center , Boston, MA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,29]]},"reference":[{"issue":"3","key":"2025092901015686500_CIT0001","doi-asserted-by":"publisher","first-page":"419","DOI":"10.5664\/jcsm.6494","article-title":"Listening to the patient voice in narcolepsy: diagnostic delay, disease burden, and treatment efficacy","volume":"13","author":"Maski","year":"2017","journal-title":"J Clin Sleep Med."},{"key":"2025092901015686500_CIT0002","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.smrv.2016.07.003","article-title":"A systematic review of cognitive function and psychosocial well-being in school-age children with 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