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  • When you think of narcolepsy, you probably think of people falling asleep at seemingly

    說到嗜睡症時,或許會想到有人能

  • random times, but it's actually much more than that.

    隨時睡著,但其實不只是這樣而已。

  • It causes hallucinations, insomnia and sleep paralysis and can be triggered by moments of joy.

    還會導致幻覺、失眠、睡眠癱瘓,而且會透過短暫的快樂引起。

  • Oh, and the key to understanding it came from studying man's best friend.

    研究人類最好的朋友是了解嗜睡症的關鍵。

  • Narcolepsy is a neurological disorder where your brain loses its ability to control its sleep-wake cycle.

    嗜睡症是種神經系統疾病,大腦失去控制睡醒週期的能力。

  • This includes symptoms like cataplexy, a condition that causes uncontrollable muscle weakness

    這包括猝倒症,無法控制肌肉無力的狀況,

  • or paralysis which is often triggered by excitement or laughter, and hypnagogic hallucinations,

    或常因興奮或笑聲引發的癱瘓症狀,以及入睡前幻覺,

  • which is basically when you start to dream before you fall asleep.

    基本上這是在入睡前就開始做夢的症狀。

  • That's great.

    很好。

  • It would be white wine.

    這應該要白酒。

  • Hello my name is Emmanuel Mignot, I'm a professor at Stanford.

    哈囉,我是 Emmanuel Mignot,我是史丹佛大學的教授

  • I'm a medical doctor and a researcher and I've been working for 30 years on a sleep disorder called narcolepsy.

    我是醫生兼研究員,我研究睡眠障礙已經超過 30 年,也就是嗜睡症。

  • Narcolepsy is a very strange disorder...

    嗜睡症是種非常奇怪的失調。

  • So initially people thought it was even a type of seizure.

    一開始大家認為它是一種癲癇。

  • But then when people looked they said no, it's not seizures, they are more sleeping.

    但仔細研究後發現不是,根本不是癲癇,比較像是睡眠。

  • But narcolepsy isn't really about falling asleep, it's about not being able to stay

    然而嗜睡症不是真的要睡著了,它是沒辦法保持清醒,

  • awake - and the role of a specific neuropeptide made in a very small region of the brain.

    特定的神經肽在大腦一個微小區域起作用。

  • The region that's called hypothalamus which is just above the optic nerve.

    那個區域叫做下視丘,位於視神經上方。

  • So very important, very primitive part of the brain that regulates sleep, appetite, very basic physiology.

    這是非常重要、非常原始的大腦部分,負責調節睡眠、食慾、非常基本的生理。

  • And these cells that produce hypocretin are all there.

    生產下視丘泌素的細胞都在這。

  • Hypocretin, also known as orexin, is a neuropeptide that is responsible for keeping you awake.

    下視丘泌素,又稱食慾素,是負責保持清醒的神經肽。

  • Once released, hypocretin travels throughout the brain activating other cells, like those

    一旦釋放,下視丘泌素會散播到整個大腦,

  • responsible for creating things like dopamine, histamine, serotonin and norepinephrine.

    刺激負責生產多巴胺、組織胺、血清素,以及去甲腎上腺素的細胞。

  • These brain cells then start to fire more, releasing their respective chemicals which,

    接著這些腦細胞會開始產生更多,釋放出各自的化學物質,

  • in turn, further stimulate your brain.

    進一步刺激大腦。

  • And the other thing it does is and that's a little bit less understood but it can also control your dreaming.

    而它所做的另一件事是,目前還不太了解,但也可以控制你的夢。

  • So is that when this chemical is absent, dreams come too strongly and too fast.

    因此,缺少這種化學物質時,夢境會變得過於強烈和快速。

  • And that's why you have all these weird symptoms of dreaming too much and the dreams are almost

    這是為什麼有這麼多奇怪的做夢症狀,

  • real and sometimes you are paralyzed at the wrong time because you are paralyzed during dreaming.

    夢境幾乎變得非常逼真,由於你在做夢時癱瘓,因此有時會在錯的時間癱瘓。

  • So the two main function of this chemical is: one is to stay awake voluntarily and the

    因此,這種化學物質主要有兩個功能:第一,自行保持清醒

  • second one is to control your dreams so that your dreams don't come too fast into wakefulness.

    第二,控制你的夢,這樣你的夢不會太快進入清醒狀態。

  • And this chemical is very important...and when it's not there you have narcolepsy.

    這種化學物質很非常重要,而一旦缺少的話,你就會得嗜睡症。

  • It took me 10 years to figure out the cause of narcolepsy in terms of losing the hypocretin cells.

    我花了十年來解開嗜睡症的原因,也就是缺少下視丘泌素。

  • Then it took me 15 years to figure out why the cells were missing.

    我又花了 15 年來解開缺少那些細胞的原因。

  • This is the Pandemic H1N1/09 virus, but you may know it as the swine flu.

    這是流行病毒 H1N1/09,不過你可能知道它是豬流感。

  • Dr Mignot and team noticed that during the 2009 swine flu pandemic, there was a significant uptick in narcolepsy cases.

    Mignot 博士和他的團隊注意到,在 2009 年豬流感的流行期間,嗜睡症的病例明顯上升。

  • And that I have to say we discovered by chance that it seems to be the flu that triggers this abnormal reaction

    我必須說,我們偶然發現這種異常反應,似乎是由流感所引發。

  • In fact we discovered that there is a piece of this 2009 swine flu that looks very much like hypocretin.

    事實上,我們發現 2009 年的豬流感有一小部分,看起來非常像下視丘泌素。

  • And then instead of attacking just the flu the cells start to attack hypocretin and then

    接著與其攻擊流感,細胞反而開始攻擊下視丘泌素

  • it kills the cells that produce it.

    還殺死其生產細胞。

  • And then once the process is started then it starts to be more and more inflamed and

    一旦這過程開始,就會變得越來越紅腫

  • then it kills the hypocretin cell thinking is the flu infected cells and then you don't

    之後就會殺死下視丘泌素,並認為它是受流感感染的細胞,接著

  • have anymore hypocretin cells and then you have narcolepsy for the rest of your life.

    你就不會再產生下視丘泌素,這樣嗜睡症就會伴隨你的餘生。

  • The immune system attacking hypocretin producing cells is why many people categorize narcolepsy

    免疫系統會攻擊生產下視丘泌素的細胞,因此許多人將嗜睡症歸為

  • as an autoimmune disease.

    自體免疫性疾病。

  • But this response doesn't happen to everyone who gets the flu virus.

    但這種反應不會發生在每個感染流感病毒的人。

  • In fact, I like to say that to develop narcolepsy, you have to have a series of bad luck.

    事實上,我會說要發展出嗜睡症,你必須要有一連串的壞運氣。

  • You know because really your immune system has to be primed a certain way and you have

    因為你的免疫系統真的必須以某種方式引發,

  • to get the flu at a certain time together with a certain immune background to genetic

    而且你必須在特定的時間內得到流感,並同時具有特定的免疫和遺傳背景

  • background to really develop narcolepsy.

    才能真正發展成嗜睡症。

  • So it's like a perfect storm to develop narcolepsy.

    這就像是發展嗜睡症的完美風暴。

  • But humans aren't the only ones to develop narcolepsy.

    但不是只有人類會發展出嗜睡症。

  • It can affect dogs and as well as horses and bulls.

    狗、馬,以及公牛都會受到影響。

  • In fact, by studying narcolepsy in dogs, Dr Mignot and others were able to initially make

    事實上,透過研究犬類的嗜睡症,Mignot 博士和其他人最初才能將

  • the connection between hypocretin and staying awake.

    下視丘必素與保持清醒連結起來。

  • And at the end you know one breakthrough was actually which found a family of dachshund with narcolepsy.

    最後,其實在有嗜睡症的臘腸狗家族中發現一項大突破

  • I still remember the dog.

    我還記得那隻狗。

  • It was Fritz.

    是叫弗里茨。

  • Narcolepsy in dogs is a genetic disease, so researchers were able to map the mutation

    狗的嗜睡症是遺傳疾病,因此研究人員能夠繪製出,

  • that caused narcolepsy in dog families, notably in Fritz, and found a very important mutation.

    在犬類家族導中致嗜睡症的突變,特別是弗里茨,而且還發現非常重要的突變。

  • And then finally we discovered that this gene was a mutation in a receptor for a chemical called orexin, or hypocretin.

    最後發現這種基因是受體突變,稱為食慾素,或下視丘泌素的化學物質。

  • From there Dr Mignot and his team were able to focus their study of narcolepsy in humans

    從那裡,Mignot 博士和他的團隊才能將嗜睡症的研究重點放在人類身上,

  • and eventually come to their breakthrough connecting it to the hypothalamus and the swine flu.

    最後將下視丘和豬流感連結起來才有大突破。

  • Fritz was really key.

    弗里茨真的很關鍵。

  • Thanks Fritz...good dog.

    謝謝弗里茨,乖狗狗。

When you think of narcolepsy, you probably think of people falling asleep at seemingly

說到嗜睡症時,或許會想到有人能

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B1 中級 中文 美國腔 細胞 流感 清醒 癱瘓 化學 物質

導致嗜睡症的原因 (Here's What Causes Narcolepsy)

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    Jerry Liu 發佈於 2019 年 07 月 20 日
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