{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:00:39Z","timestamp":1790622039535,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Narcolepsy is classified as type 1 (NT1) or type 2 (NT2) mainly according to hypocretin deficiency rather than cataplexy. While CRH neuron loss in the PVN has been described in NT1, it remains unclear whether similar changes occur in narcolepsy without cataplexy. We report a 42\u2010year\u2010old woman with excessive daytime sleepiness since age 15, without cataplexy. Two multiple sleep latency tests and lumbar punctures performed 8\u2009years apart showed mean latencies of 8.3\u2009min with three SOREMPs and 10.8\u2009min with two SOREMPs, along with borderline low\u2010intermediate hypocretin\u20101 levels of 100\u2009pg\/mL initially and 122\u2009pg\/mL at follow\u2010up. HLA DQB1*06:02 was positive, and brain magnetic resonance imaging was normal. The patient later developed severe depression and committed suicide. CRH neuron counts were compared with a control and a NT1 hypothalamus. All hypothalami were formalin\u2010fixed, paraffin\u2010embedded and processed for thionin staining and immunohistochemistry for hypocretin and CRH, with neurons manually counted. Only the anterior hypothalamus was available from this case, precluding the assessment of hypocretin neurons, although CSF levels indicated a borderline low\u2010intermediate reduction. Thionin staining confirmed that the PVN was fully included in our case and revealed an almost complete loss of CRH\u2010positive neurons in the PVN compared with controls, consistent with findings in NT1. This report indicates that narcolepsy without cataplexy, accompanied by borderline low CSF hypocretin\u20101 levels, is associated with a marked reduction in CRH neurons in the PVN, which may contribute to excessive daytime sleepiness and impaired wakefulness regulation, without triggering cataplexy.<\/jats:p>","DOI":"10.1111\/jsr.70395","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:51:51Z","timestamp":1782402711000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postmortem Evidence of\n                    <scp>CRH<\/scp>\n                    Neuron Reduction in Narcolepsy Without Cataplexy With Borderline Hypocretin\u20101 Levels"],"prefix":"10.1111","volume":"35","author":[{"given":"Ling","family":"Shan","sequence":"first","affiliation":[{"name":"Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience An Institute of the Royal Netherlands Academy of Arts and Sciences  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan","family":"Linssen","sequence":"additional","affiliation":[{"name":"Department Neuropsychiatric Disorders, Netherlands Institute for Neuroscience An Institute of the Royal Netherlands Academy of Arts and Sciences  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1935-7603","authenticated-orcid":false,"given":"Rolf","family":"Fronczek","sequence":"additional","affiliation":[{"name":"Department of Neurology Leiden University Medical Centre  Leiden the Netherlands"},{"name":"Sleep Wake Centre SEIN  Heemstede the Netherlands"},{"name":"Stichting Epilepsie Instellingen Nederland (SEIN) Sleep\u2010Wake Centre  Heemstede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Barateau","sequence":"additional","affiliation":[{"name":"Sleep\u2010Wake Disorders Unit, Department of Neurology Gui\u2010de\u2010Chauliac Hospital, CHU  Montpellier France"},{"name":"National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine\u2010Levin Syndrome  Montpellier France"},{"name":"Institute of Neurosciences of Montpellier University of Montpellier, INSERM  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Peyron","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Neurosciences de Lyon, CNRS UMR5292, Inserm U1028 Universit\u00e9 Claude\u2010Bernard\u2010Lyon1  Bron France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0683-6506","authenticated-orcid":false,"given":"Yves","family":"Dauvilliers","sequence":"additional","affiliation":[{"name":"Sleep\u2010Wake Disorders Unit, Department of Neurology Gui\u2010de\u2010Chauliac Hospital, CHU  Montpellier France"},{"name":"National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine\u2010Levin Syndrome  Montpellier France"},{"name":"Institute of Neurosciences of Montpellier University of Montpellier, INSERM  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"ICSD\u20103 TR: International Classification of Sleep Disorders","author":"AASM: American Academy of Sleep Medicine","year":"2023"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.2080"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-3639.2008.00135.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0226-9"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3756"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-63118-6"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15951-5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9861(20000724)423:2<299::AID-CNE8>3.0.CO;2-A"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2020.101306"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abc2590"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abd0384"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/79690"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab285"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26300"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26736"},{"key":"e_1_2_9_17_1","volume-title":"The Human Hypothalamus: Basic and Clinical Aspects. 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