Contribution of brainstem circuits in pathophysiology of NREM-sleep parasomnias

Violent and Complex Behaviors and Non-Restorative Sleep Are the Main Features of Disorders of Arousal in Adulthood: Real Picture or a More Severe Phenotype?

“…On the left, neurophysiologic studies directly analyzing DoA episodes are illustrated [15][16][17][18][19][20][22][23][24][25][26]30,32,34,36,[40][41][42]. On the right are neurophysiologic studies that analyzed DoA patients independently of the episodes (nocturnal sleep detached from episodes/wakefulness) [21,27,29,31,33,35,37,38,43,44]…”

“…Beyond the study of the episode itself, other different neurophysiologic assessments (Figure 1) disclosed increased excitability of motor areas [21,29], decreased activity of frontal areas after sleep deprivation [35], alteration of excitatory brainstem networks [38], a higher ability to perform complex locomotor actions in an unaware condition (under cognitive load) [33] and related EEG markers (higher beta power) corresponding to a higher capacity to perform automatic movements [43]. Even slight structural changes were encountered in an MRI study, characterized by a decrease in gray matter volume of the dorsal posterior cingulate cortex [31].…”

“…On the left, neurophysiologic studies directly analyzing DoA episodes are illustrated[15][16][17][18][19][20][22][23][24][25][26]30,32,34,36,[40][41][42]. On the right are neurophysiologic studies that analyzed DoA patients independently of the episodes (nocturnal sleep detached from episodes/wakefulness)[21,27,29,31,33,35,37,38,43,44].Listed studies are circled by either blue or red discs, respectively indicating if performed during sleep or wakefulness. "*" and "**", respectively, indicate studies performed under sleep deprivation or with a specific cognitive load.…”