Neuroimaging in the Rare Sleep Disorder of Kleine–Levin Syndrome: A Systematic Review

Round 1

Reviewer 1 Report

This paper entitled “Neuroimaging in Kleine Levine Syndrome: A Systematic Review” reviews recent progress in Kleine Levine Syndrome(KLS). They focused on neuroimaging findings within 20 years. The authors systematically analyzed different brain regions that potentially link to KLS in asymptomatic and symptomatic periods and concluded that abnormal activity in thalamus and hypothalamus were tightly correlated with working memory deficits. Overall, the topic of this review is important.  This paper is clear structured and well written. I have the following comments to improve it prior to publication.

1. It would be better to have a figure that summarize the contents that  compare the difference in brain regions in asymptomatic vs symptomatic periods.
2. Given the fact that quite a few readers don’t have background in neuro imaging in human brain. I believe a table that briefly explaining all the imaging techniques mentioned in this paper will be helpful.
3. Several studies suggest that abnormal neural activity in the striatum of patients with KLS (as in ref 10,16 in the paper, as well as Drouet et al., 2017). Therefore, it'll be worth to include the role of the striatum in KLS.
4. Title of the table 4 was missing in the paper. Also Engstorm et al., 2013 was 12th in the reference list not 14th.

Author Response

Dear reviewer,

Thank you for providing these edits and going over the paper with such detail; please find in the attachment all the corrections made (yours and the other reviewers).

Best Regards, 

Juan Ortiz

 

Author Response File: Author Response.docx

Reviewer 2 Report

This study provided a review into KLS correlation with neuroimage within the recent years, aims to present some conflicting findings across imaging techniques. Overall, this work is helpful to provide useful insight into clinical research. Some comments could be helpful.

1. Actually, this study looks like a report, instead of a systematic review, since the lack of analysis, insight, and inspiration obtained from these collected publications. More discussion about the new insight or inspiration is necessary.

2. Need to include more discussion to the recent publications about Kleine Levin, better under the recent three years.

3. In the both abstract and conclusion, "We find that the symptoms in KLS seems to be correlation with functional imaging.". This conclusion does make no sense since these conclusions are too rough. Does not provide readers with enlightening knowledge.

4. Where is the title of Section.2?

5. Before Section.2, you should include the research motion and purpose. 

6. What do you mean by "observational studies". How did you define the word?

7. In section 2.4, how's possible be a chapter with just one sentence?

 

 

 

 

Author Response

Dear reviewer,

Thank you for providing these edits and going over the paper with such detail; please find in the attachment all the corrections made (yours and the other reviewers).

Best Regards, 

Juan Ortiz

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

The authors have addressed all of my concerns and have substantially improved the manuscript. I have no more questions.

Author Response

Grammar editing was conducted in the document, additionally there was a correction in the imaging technique table.