In 2010, the H1N1 Pandemrix vaccination campaign was followed by a sudden increase in narcolepsy type 1 (NT1). We investigated the brain white matter microstructure in children with onset of NT1 within two years after the Pandemrix vaccination. We performed diffusion-weighted magnetic resonance imaging (MRI) on 19 children and adolescents with NT1 and 19 healthy controls. Imaging was performed at a median of 4 years after the diagnosis at a median age of 16 years. For the MRI, we used whole-brain tractography and tract-based spatial statistics (TBSS). We compared these results with medical records and questionnaire data. Narcoleptic children showed a global decrease in mean, axial, and radial diffusivity and an increase in planarity coefficient in the white matter TBSS skeleton and tractography. These differences were widespread, and there was an increased asymmetry of the mean diffusivity in children with NT1. The global microstructural metrics were reflected in behavior, and especially the axial diffusion levels correlated with anxiety and depression symptoms and social and behavioral problems. In pediatric patients with Pandemrix-associated NT1, several global changes in the brain white matter network skeleton were observed within five years after the onset of NT1. The degree of changes correlates with behavioral problems.

中文翻译：

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患有 1 型发作性睡病的儿童和青少年的微结构白质异常

2010 年，H1N1 Pandemrix 疫苗接种运动之后，1 型发作性睡病 (NT1) 突然增加。我们研究了 Pandemrix 疫苗接种后两年内出现 NT1 的儿童的脑白质微结构。我们对 19 名患有 NT1 的儿童和青少年以及 19 名健康对照者进行了弥散加权磁共振成像 (MRI)。影像学检查是在诊断后平均 4 年进行的，平均年龄为 16 岁。对于 MRI，我们使用全脑束成像和基于束的空间统计 (TBSS)。我们将这些结果与医疗记录和问卷数据进行了比较。发作性睡病儿童的白质 TBSS 骨骼和纤维束成像显示平均、轴向和径向扩散率整体下降，平面系数增加。这些差异很普遍，并且 NT1 儿童的平均扩散率不对称性增加。整体微观结构指标反映在行为中，尤其是与焦虑和抑郁症状以及社会和行为问题相关的轴向扩散水平。在患有 Pandemrix 相关 NT1 的儿科患者中，在 NT1 发病后五年内观察到大脑白质网络骨架的一些整体变化。变化的程度与行为问题相关。