Name: 導致嗜睡症的原因 (Here's What Causes Narcolepsy)
Uploaded: 2019-07-20T03:27:06.000Z
Duration: 4 min 57 s

情態副詞

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。

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。

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，

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

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

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

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

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。