Supplementary file 1_Chronic pain in narcolepsy reflects interacting neurobiological and psychological mechanisms: a mini-review.pdf

This mini review summarizes and discusses current evidence on links between narcolepsy type 1 (NT1) and type 2 (NT2) and chronic pain, exploring whether pain is best understood as a consequence of the pathophysiology or secondary to its manifestations and comorbidities. Registry-based and self-reported data indicate a high prevalence of chronic pain in NT1, while objective pain tests show inconsistent differences between NT1 and healthy individuals.

This discrepancy suggests involvement of secondary mechanisms not readily captured by experimental pain testing. Comparable pain prevalence in NT1 and NT2 also speaks against orexin deficiency as a sole driver of chronic pain in NT1. Alternatively, altered dopaminergic signaling downstream of orexin could be a shared contributor to pain in NT1 and other fatigue-related conditions.