Polysomnography (PSG) is considered the gold standard for diagnosis of non-rapid eye movement (NREM) parasomnias, however its diagnostic yield has been rarely reported. We aimed to assess the diagnostic value of polysomnography in different categories of patients with suspected NREM parasomnia and define variables that can affect the outcome. 124 adults referred for polysomnography for suspected NREM parasomnia were retrospectively identified and divided into clinical categories based on their history. Each polysomnography was analysed for features of NREM parasomnia or different sleep disorders and for presence of potential precipitants. The impact on the outcome of number of recording nights and concomitant consumption of benzodiazepines and antidepressants was assessed. Overall, PSG confirmed NREM parasomnias in 60.5 % patients and showed a different sleep disorder in another 16 %. Precipitants were found in 21 % of the 124 patients. However, PSG showed limited value when the NREM parasomnia was clinically uncomplicated, since it rarely revealed a different diagnosis or unsuspected precipitants (5 % respectively), but became essential for people with unusual features in the history where different or overlapping diagnoses (18 %) or unsuspected precipitants (24 %) were commonly identified. Taking benzodiazepines or antidepressants during the PSG reduced the diagnostic yield. PSG has a high diagnostic yield in patients with suspected NREM parasomnia, and can reveal a different diagnosis or precipitants in over 40 % of people with complicated or atypical presentation or those with a history of epilepsy. We suggest that PSG should be performed for one night in the first instance, with leg electrodes and respiratory measurements and after benzodiazepine and antidepressant withdrawal.

PH-DBS, a promising treatment for severe refractory TACs, affects sleep quality and pre-existing sleep disorders. This needs to be considered when treating patients with PH-DBS.

Study Objectives: To compare the amounts of REM sleep without atonia (RSWA) between patients with REM sleep behavior disorder (RBD), "isolated loss of REM atonia," narcolepsy, and control subjects and determine if there were threshold values for the amount of RSWA that differentiate each group from controls. Methods: Retrospective analyses of polysomnography (PSG) records were used employing strict quantitative criteria for the measurement of phasic and tonic EMG activity during REM sleep. The PSG recordings of 47 individuals were analyzed (RBD 16, isolated loss of REM atonia 11, narcolepsy 10, control 10). Results: Patients with the diagnosis of isolated loss of REM atonia had signifi cantly lower levels of EMG activity during REM sleep than those with RBD but higher than control subjects. RSWA was higher in narcolepsy than in loss of REM atonia but lower than for RBD patients. Receiver operating characteristic (ROC) curves provided threshold values with high specifi city and sensitivity in all patient groups with a cutoff value ≥ 1.22% (100% correctly classifi ed) for phasic and ≥ 3.17% for tonic (92% correctly classifi ed) EMG activity in RBD. Conclusion S C I E N T I F I C I N V E S T I G A T I O N SR EM sleep behavior disorder (RBD) is a parasomnia characterized by loss of normal muscle atonia during REM sleep with abnormal motor activity that is proposed to be associated with dream content.1 RBD is associated with neurodegenerative disorders and in particular with synucleinopathies such as Parkinson disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA) (secondary RBD). Long-term follow-up studies have shown that a large proportion (38% to 65%) of patients with presumed idiopathic RBD develop Parkinsonism and/or dementia.2,3 EEG and neuropsychological tests have also revealed early evidence of CNS dysfunction in idiopathic RBD patients.4-7 Furthermore, diffusion tensor imaging has uncovered microstructural abnormalities in the brain areas responsible for REM sleep regulation in idiopathic RBD patients. In addition to neurodegenerative disease, RBD is also associated with other sleep disorders. Periodic limb movements of sleep (PLMS) are highly prevalent (70%) in patients with RBD.5 In addition, RBD is frequently seen in patients with narcolepsy.9,10 REM sleep without atonia (RSWA) in narcolepsy was fi rst described in 1992.10 RBD and/or RSWA are thought to be common in narcolepsy with cataplexy and rare in narcolepsy without cataplexy. 11,12It has been proposed that hypocretin defi ciency plays an essential role for both RBD and cataplexy in narcolepsy. Department of Clinical and Experimental Epilepsy, Institute of Neurology, UCL, London UKIsolated loss of REM atonia or RSWA is a condition usually identifi ed incidentally in patients during polysomnography. The loss of REM atonia is an electrophysiological fi nding without accompanying abnormal motor behavior during REM sleep. Although the condition may represent "subclinical" or "preclinical" RBD in some cases, 14 there are no ...

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Background:During the last decade, the use of mobile electroencephalography (EEG) devices has furthered understanding of the mechanisms that underlie psychophysical and affective responses during the execution of gross movements (e.g. walking and cycling). Such devices can also be used to shed new light on the mechanisms that underlie attention allocation, fatigue-related symptoms, emotional reactions, and behavioural outcomes associated with physical activity programmes. This advancement could, potentially, herald a new era for the field of sport and exercise psychology, wherein researchers will be able to investigate athletic performance and exercise behaviour from a different perspective.Objective:In this review, we explore some of the most recent approaches used to measure electrical activity in the brain during exercise.Practical recommendations:We provide an overview of the practical issues that researchers face in this field, such as dealing with artefacts elicited by body and cable movements and how to process the biological signal. We also review methods that researchers can employ to prevent electrical artefacts from compromising the fidelity of data. We make a case for assessing psychological and psychobiological parameters in tandem with EEG in order to arrive at a fuller understanding of exercise-related phenomena.