0663 Assessing the Predictive Accuracy of Quantitative Electroencephalography in the Diagnosis of Narcolepsy

Abstract Introduction Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness (EDS), disturbed nocturnal sleep, and features of rapid eye movement (REM) sleep dissociation (i.e., cataplexy, hypnagogic hallucinations, sleep paralysis, and shortened REM-onset latency). the diagnosis is typically made by a multiple sleep latency test (MSLT), with reported sensitivity of 90% and specificity of 95%. However, MSLT can be difficult to schedule and can be influenced by other factors, such as anxiety, fear, and prescription medications (e.g., antidepressants). Building upon previous research demonstrating frequency- and region-specific electroencephalographic (EEG) imbalances in patients with narcolepsy, the present study aimed to assess the ability of quantitative electroencephalography (qEEG) to diagnose narcolepsy as compared to the reference standard MSLT. Methods Patients seen at an integrative health center in Houston, TX and identified with symptoms of narcolepsy, including chronic fatigue, underwent qEEG. If qEEG was concerning for narcolepsy, patients were referred to a sleep specialist and were included if they subsequently underwent an MSLT. Results Seventy-three patients (64 females, 9 males) were recruited with a mean age of 35±12.5 years. Of these, 35 patients had cataplexy. Sixty-nine (94.5%) of the 73 patients with positive qEEG had positive MSLT for narcolepsy: 31 (88.6%) in the cataplexy group and 38 (100%) in the non-cataplexy group. Of the remaining 4 patients, 2 had idiopathic hypersomnia on MSLT. Conclusion The findings suggest that qEEG holds promise as a valuable tool for diagnosing narcolepsy, potentially contributing to improved and timely clinical assessments. While potential variations in accuracy within specific symptoms should be considered, more research in the same population sample should evaluate the role of frequency- and region-specific EEG imbalances. Support (if any)