To evaluate functional connectivity and topological properties of brain networks, and to investigate the association between brain topological properties and neuropsychiatric behaviors in adolescent narcolepsy.
Resting-state functional magnetic resonance imaging and neuropsychological assessment were applied in 26 adolescent narcolepsy patients and 30 healthy controls. Functional magnetic resonance imaging data were analyzed in 3 ways: group independent component analysis and a graph theoretical method were applied to evaluate topological properties within the whole brain. Lastly, network-based statistics was utilized for group comparisons in region-to-region connectivity. The relationship between topological properties and neuropsychiatric behaviors was analyzed with correlation analyses.
In addition to sleepiness, depressive symptoms and impulsivity were detected in adolescent narcolepsy. In adolescent narcolepsy, functional connectivity was decreased between regions of the limbic system and the default mode network, and increased in the visual network. Adolescent narcolepsy patients exhibited disrupted small-world network properties. Regional alterations in the caudate nucleus and posterior cingulate gyrus were associated with subjective sleepiness and regional alterations in the caudate nucleus and inferior occipital gyrus were associated with impulsiveness. Remodeling within the salience network and the default mode network was associated with sleepiness, depressive feelings and impulsive behaviors in narcolepsy.
Alterations in brain connectivity and regional topological properties in narcoleptic adolescents were associated with their sleepiness, depressive feelings and impulsive behaviors.

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