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Badrfam R, Zandifar A. Status dissociatus and movement disorders in anti N-methyl-d-aspartate receptor (anti NMDAR) encephalitis; diagnostic challenges ahead. Gen Hosp Psychiatry 2024; 88:75-76. [PMID: 38278744 DOI: 10.1016/j.genhosppsych.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/20/2024] [Accepted: 01/21/2024] [Indexed: 01/28/2024]
Affiliation(s)
- Rahim Badrfam
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Atefeh Zandifar
- Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Sadoc M, Clairembault T, Coron E, Berthomier C, Le Dily S, Vavasseur F, Pavageau A, St Louis EK, Péréon Y, Neunlist M, Derkinderen P, Leclair-Visonneau L. Wake and non-rapid eye movement sleep dysfunction is associated with colonic neuropathology in Parkinson's disease. Sleep 2024; 47:zsad310. [PMID: 38156524 DOI: 10.1093/sleep/zsad310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/04/2023] [Indexed: 12/30/2023] Open
Abstract
STUDY OBJECTIVES The body-first Parkinson's disease (PD) hypothesis suggests initial gut Lewy body pathology initially propagates to the pons before reaching the substantia nigra, and subsequently progresses to the diencephalic and cortical levels, a disease course presumed to likely occur in PD with rapid eye movement sleep behavior disorder (RBD). We aimed to explore the potential association between colonic phosphorylated alpha-synuclein histopathology (PASH) and diencephalic or cortical dysfunction evidenced by non-rapid eye movement (NREM) sleep and wakefulness polysomnographic markers. METHODS In a study involving 43 patients with PD who underwent clinical examination, rectosigmoidoscopy, and polysomnography, we detected PASH on colonic biopsies using whole-mount immunostaining. We performed a visual semi-quantitative analysis of NREM sleep and wake electroencephalography (EEG), confirmed it with automated quantification of spindle and slow wave features of NREM sleep, and the wake dominant frequency, and then determined probable Arizona PD stage classifications based on sleep and wake EEG features. RESULTS The visual analysis aligned with the automated quantified spindle characteristics and the wake dominant frequency. Altered NREM sleep and wake parameters correlated with markers of PD severity, colonic PASH, and RBD diagnosis. Colonic PASH frequency also increased in parallel to probable Arizona PD stage classifications. CONCLUSIONS Colonic PASH is strongly associated with widespread brain sleep and wake dysfunction, suggesting an extensive diffusion of the pathologic process in PD. Visual and automated analyses of polysomnography signals provide useful markers to gauge covert brain dysfunction in PD. CLINICAL TRIAL Name: SYNAPark, URL: https://clinicaltrials.gov/study/NCT01748409, registration: NCT01748409.
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Affiliation(s)
- Mathilde Sadoc
- Laboratoire d'Explorations Fonctionnelles, CHU Nantes, Nantes, France
- Department of Neurology, CHU Nantes, Nantes, France
| | - Thomas Clairembault
- INSERM, TENS The Enteric Nervous System in Gut and Brain Diseases, Nantes, France
- Nantes Université, Nantes, France
- CHU Nantes, Institut des Maladies de l'Appareil Digestif, Nantes, France
| | - Emmanuel Coron
- INSERM, TENS The Enteric Nervous System in Gut and Brain Diseases, Nantes, France
- Nantes Université, Nantes, France
- CHU Nantes, Institut des Maladies de l'Appareil Digestif, Nantes, France
- Inserm, CIC-04, Nantes, France
| | | | | | - Fabienne Vavasseur
- CHU Nantes, Institut des Maladies de l'Appareil Digestif, Nantes, France
- Inserm, CIC-04, Nantes, France
| | - Albane Pavageau
- Laboratoire d'Explorations Fonctionnelles, CHU Nantes, Nantes, France
| | - Erik K St Louis
- Mayo Sleep Behavior and Neurophysiology Research Laboratory, Department of Neurology, Rochester, MN, USA
- Mayo Center for Sleep Medicine, Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Yann Péréon
- Laboratoire d'Explorations Fonctionnelles, CHU Nantes, Nantes, France
- Nantes Université, Nantes, France
| | - Michel Neunlist
- INSERM, TENS The Enteric Nervous System in Gut and Brain Diseases, Nantes, France
- Nantes Université, Nantes, France
- CHU Nantes, Institut des Maladies de l'Appareil Digestif, Nantes, France
| | - Pascal Derkinderen
- Department of Neurology, CHU Nantes, Nantes, France
- INSERM, TENS The Enteric Nervous System in Gut and Brain Diseases, Nantes, France
- Nantes Université, Nantes, France
- Inserm, CIC-04, Nantes, France
| | - Laurène Leclair-Visonneau
- Laboratoire d'Explorations Fonctionnelles, CHU Nantes, Nantes, France
- INSERM, TENS The Enteric Nervous System in Gut and Brain Diseases, Nantes, France
- Nantes Université, Nantes, France
- Inserm, CIC-04, Nantes, France
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3
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Onofrj M, Russo M, Delli Pizzi S, De Gregorio D, Inserra A, Gobbi G, Sensi SL. The central role of the Thalamus in psychosis, lessons from neurodegenerative diseases and psychedelics. Transl Psychiatry 2023; 13:384. [PMID: 38092757 PMCID: PMC10719401 DOI: 10.1038/s41398-023-02691-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/06/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023] Open
Abstract
The PD-DLB psychosis complex found in Parkinson's disease (PD) and Dementia with Lewy Bodies (DLB) includes hallucinations, Somatic Symptom/Functional Disorders, and delusions. These disorders exhibit similar presentation patterns and progression. Mechanisms at the root of these symptoms also share similarities with processes promoting altered states of consciousness found in Rapid Eye Movement sleep, psychiatric disorders, or the intake of psychedelic compounds. We propose that these mechanisms find a crucial driver and trigger in the dysregulated activity of high-order thalamic nuclei set in motion by ThalamoCortical Dysrhythmia (TCD). TCD generates the loss of finely tuned cortico-cortical modulations promoted by the thalamus and unleashes the aberrant activity of the Default Mode Network (DMN). TCD moves in parallel with altered thalamic filtering of external and internal information. The process produces an input overload to the cortex, thereby exacerbating DMN decoupling from task-positive networks. These phenomena alter the brain metastability, creating dreamlike, dissociative, or altered states of consciousness. In support of this hypothesis, mind-altering psychedelic drugs also modulate thalamic-cortical pathways. Understanding the pathophysiological background of these conditions provides a conceptual bridge between neurology and psychiatry, thereby helping to generate a promising and converging area of investigation and therapeutic efforts.
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Affiliation(s)
- Marco Onofrj
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, Institute for Advanced Biomedical Technology-ITAB University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
| | - Mirella Russo
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, Institute for Advanced Biomedical Technology-ITAB University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Stefano Delli Pizzi
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, Institute for Advanced Biomedical Technology-ITAB University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Danilo De Gregorio
- Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonio Inserra
- Neurobiological Psychiatry Unit, McGill University, Montreal, QC, Canada
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, McGill University, Montreal, QC, Canada
| | - Stefano L Sensi
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology - CAST, Institute for Advanced Biomedical Technology-ITAB University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
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Rosamaria L, Michela F, Emma B, Ana M, Bruno P, Philippe D, Bérangère D, Raffaele F, Monica P, Franck D, Maria Livia F. Strained face during sleep in multiple system atrophy: not just a bad dream. Sleep 2023; 46:zsad180. [PMID: 37463431 DOI: 10.1093/sleep/zsad180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/08/2023] [Indexed: 07/20/2023] Open
Abstract
STUDY OBJECTIVES Patients with Parkinson's disease and multiple system atrophy may be subject to sleep state dissociation. Motivated by the fortuitous observation of prominent facial muscle activity during video-polysomnography in patients with multiple system atrophy, we assessed facial motor activity and chin muscle tone during sleep in multiple system atrophy compared to Parkinson's disease and controls. METHODS A sleep expert blinded to pathology and sleep stage retrospectively analyzed facial activity in 62 video-polysomnography (11 multiple system atrophy, 38 Parkinson's disease, and 13 controls). Facial movements were classified into six categories: "Eyes closing/opening," "Eyebrows frowning," "Raising eyebrows," "Smiling," "Other mouth movements," and "Strained face," an expression involving both the superior and inferior parts of the face. Chin electromyography activity was quantified during Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep using the atonia index, a validated algorithm. RESULTS Multiple system atrophy patients had an increased number of all facial movements compared to controls during NREM. "Strained face" was significantly more frequent in multiple system atrophy compared to Parkinson's disease, even after adjusting for the presence of REM sleep behavior disorder (RBD). Atonia index was lower in multiple system atrophy compared to controls and Parkinson's disease during REM and NREM sleep. This difference remained significant compared to Parkinson's disease in NREM sleep during N1 and N2 after adjusting for the presence of RBD. CONCLUSIONS Facial movements during sleep are frequent in multiple system atrophy, "strained face" appears to be a hallmark of this condition. The presence of increased facial activity and elevated muscle tone during all stages of sleep in multiple system atrophy may be a manifestation of sleep state dissociation, reflecting more severe neurodegeneration.
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Affiliation(s)
- Lecca Rosamaria
- Sleep and EEG, Neurophysiology Unit, Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
- Sleep Disorder Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Figorilli Michela
- Sleep Disorder Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Bouniol Emma
- Sleep and EEG, Neurophysiology Unit, Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Marques Ana
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Pereira Bruno
- Biostatistics Unit, Department of Clinical Research and Innovation Direction (DRCI), CHU Clermont-Ferrand, France
| | - Derost Philippe
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Debilly Bérangère
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Ferri Raffaele
- Sleep Research Centre, Department of Neurology I.C., Oasi Research Institute - IRCCS, Troina, Italy
| | - Puligheddu Monica
- Sleep Disorder Center, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Durif Franck
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
| | - Fantini Maria Livia
- Sleep and EEG, Neurophysiology Unit, Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
- Neurology Department, CHU University Hospital and UMR 6602-Université Clermont Auvergne, CNRS, Institute Pascal, Clermont-Ferrand, France
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Gnoni V, Duncan I, Wasserman D, Higgins S, Drakatos P, Birdseye A, Pérez-Carbonell L, Nesbitt A, Koutroumanidis M, Leschziner G, Rosenzweig I. Nocturnal visual hallucinations in patients with disorders of arousal: a novel behavioral and EEG pattern. Croat Med J 2022. [PMID: 36325668 PMCID: PMC9648088 DOI: 10.3325/cmj.2022.63.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate clinical and video-polysomnography (VPSG) findings of hallucinatory experiences in patients suffering from disorders of arousal (DOA) in the absence of other pathologies. METHODS The authors retrospectively reviewed the records of 370 adults with DOA. Thirty (8.1%) patients concomitantly reported complex nocturnal visual hallucinations. VPSG recordings were scrutinized, and motor behavioral and electroencephalogram (EEG) patterns were classified according to previous descriptions of DOA. RESULTS Thirty DOA patients reported seeing images of objects, people, and animals; either distorted, static, or mobile. The images disappeared with increased illumination in 80% of patients, and 23.3% reported preceding dream imagery. In addition to the classical DOA patterns on VPSG, a distinct pattern of behavioral and EEG manifestation associated with complex hallucinatory episodes was identified in 16 (53.3%) DOA patients. This consisted of low-voltage mixed-frequency EEG activity before eye opening that persisted while patients were observed staring or visually tracking before the onset of motor behavior. CONCLUSION A novel, distinct behavioral and EEG pattern in patients with DOA and history of reported complex nocturnal visual hallucinations was identified. This may represent a unique phenotype of dissociation between sleep states that merits further investigation.
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Affiliation(s)
- Valentina Gnoni
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
| | - Iain Duncan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
| | - Danielle Wasserman
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sean Higgins
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
| | - Panagis Drakatos
- Sleep Disorders Centre, Guy's Hospital, London, UK,Faculty of Life Sciences and Medicine King’s College London, London, UK
| | | | | | - Alexander Nesbitt
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK,Department of Neurology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Guy Leschziner
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK,Department of Neurology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,Sleep Disorders Centre, Guy's Hospital, London, UK
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Prasertpan T, Phuenpathom W, Bhidayasiri R, Sringean J. An Elderly Man With Chaotic Sleep Behaviors and Rapidly Progressive Ataxia. Mov Disord Clin Pract 2022; 9:S36-S40. [PMID: 36118510 PMCID: PMC9464990 DOI: 10.1002/mdc3.13537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tittaya Prasertpan
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital. Thai Red Cross SocietyBangkokThailand
| | - Warongporn Phuenpathom
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital. Thai Red Cross SocietyBangkokThailand
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital. Thai Red Cross SocietyBangkokThailand
- The Academy of ScienceThe Royal Society of ThailandBangkokThailand
| | - Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital. Thai Red Cross SocietyBangkokThailand
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Adaptive Solutions to the Problem of Vulnerability During Sleep. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2022. [DOI: 10.1007/s40806-022-00330-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractSleep is a behavioral state whose quantity and quality represent a trade-off between the costs and benefits this state provides versus the costs and benefits of wakefulness. Like many species, we humans are particularly vulnerable during sleep because of our reduced ability to monitor the external environment for nighttime predators and other environmental dangers. A number of variations in sleep characteristics may have evolved over the course of human history to reduce this vulnerability, at both the individual and group level. The goals of this interdisciplinary review paper are (1) to explore a number of biological/instinctual features of sleep that may have adaptive utility in terms of enhancing the detection of external threats, and (2) to consider relatively recent cultural developments that improve vigilance and reduce vulnerability during sleep and the nighttime. This paper will also discuss possible benefits of the proposed adaptations beyond vigilance, as well as the potential costs associated with each of these proposed adaptations. Finally, testable hypotheses will be presented to evaluate the validity of these proposed adaptations.
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Ralls F, Cutchen L, Grigg-Damberger MM. Recognizing New-Onset Sleep Disorders in Autoimmune Encephalitis Often Prompt Earlier Diagnosis. J Clin Neurophysiol 2022; 39:363-371. [PMID: 35239557 DOI: 10.1097/wnp.0000000000000820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY Sleep/wake disorders are common in patients with autoimmune encephalitis, sometimes the most prominent or sole initial symptom, then delaying diagnosis. Sleep/wake disorders in autoimmune encephalitis vary and include severe sleeplessness, hypersomnia, central and/or obstructive sleep apnea, rapid eye movement sleep behavior disorder, indeterminate sleep/wake states, and loss of circadian sleep/wake rhythms. N-methyl- d aspartate receptor encephalitis (NMDAR) is often associated with insomnia, then hypersomnia and sleep-related central hypoventilation. Profound sleeplessness and rapid eye movement sleep behavior disorder are seen in patients with voltage-gated potassium channel-complex antibodies. Fragmented sleep and hypersomnia are common in paraneoplastic syndromes associated with anti-MA protein encephalitis; rapid eye movement sleep behavior disorder in those with antibodies against leucine-rich glioma inactivated protein (LGI1) or contactin-associated protein 2 (CASPR2) antibodies. Antibodies against a cell adhesion protein IGLON5 may result in obstructive sleep apnea, inspiratory stridor, disorganized nonrapid eye movement sleep, and excessive movements and parasomnias fragmenting nonrapid and rapid eye movement sleep. Recognizing a particular sleep/wake disorder is often a presenting or prominent feature in certain autoimmune encephalitis permit for earlier diagnosis. This is important because reduced morbidity and better short- and long-term outcomes are associated with earlier diagnosis and immunotherapies.
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Affiliation(s)
- Frank Ralls
- New Mexico Sleep Labs, Rio Rancho, New Mexico, U.S.A
| | - Lisa Cutchen
- Omni Sleep, Albuquerque, New Mexico, U.S.A.; and
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Lynn SJ, Polizzi C, Merckelbach H, Chiu CD, Maxwell R, van Heugten D, Lilienfeld SO. Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework. Annu Rev Clin Psychol 2022; 18:259-289. [PMID: 35226824 DOI: 10.1146/annurev-clinpsy-081219-102424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identify empirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Steven Jay Lynn
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Craig Polizzi
- Psychology Department, Binghamton University, Binghamton, New York, USA;
| | - Harald Merckelbach
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Chui-De Chiu
- Department of Psychology, Chinese University of Hong Kong, Hong Kong, China
| | - Reed Maxwell
- Department of Psychiatry, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dalena van Heugten
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Fénelon G. From Dreams to Hallucinations: Jean Lhermitte's Contribution to the Study of Peduncular Hallucinosis and the Dissociation of States. J Neuropsychiatry Clin Neurosci 2022; 34:16-29. [PMID: 34711070 DOI: 10.1176/appi.neuropsych.20120314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Jean Lhermitte (1877-1959) was one of the pioneers of behavioral neurology, including the field of hallucinations. This article focuses on his work concerning the relationship between hallucinations, sleep, and dreams. From 1910, Lhermitte became interested in sleep and its disorders, particularly narcolepsy and its accompanying symptoms. He also reported on sleep disorders and hallucinations occurring in people with lesions of the diencephalic region ("infundibular syndrome"), and later encephalitis lethargica. In 1922, he described a syndrome of complex, predominantly visual hallucinations in patients with vascular damage to the midbrain, known as peduncular hallucinosis. Twelve historical cases of peduncular hallucinosis, including 10 from Lhermitte, are reviewed. He gave a precise phenomenological description of peduncular hallucinosis, and put forward the hypothesis that the lesion disrupted the anatomy and connections of a center regulating wakefulness and sleep, thus enabling a dissociation of the mechanisms of dream and waking states. Although the pathophysiology of peduncular hallucinosis remains to this day partly obscure, the model of a limited subcortical lesion acting through complex mechanisms and ultimately involving the cortex remains valid. Lhermitte was also a pioneer in characterizing what contemporary sleep specialists call dissociation of states.
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Affiliation(s)
- Gilles Fénelon
- Service de Neurologie, Centre Expert Parkinson, Hôpital Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France; Département d'Etudes Cognitives, École Normale Supérieure, Paris Sciences et Lettres University, Paris; and Equipe NeuroPsychologie Interventionnelle, Institut Mondor de Recherche Biomédicale, Paris-Est Créteil Val-de-Marne University, Créteil, France
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Rechichi I, Iadarola A, Zibetti M, Cicolin A, Olmo G. Assessing REM Sleep Behaviour Disorder: From Machine Learning Classification to the Definition of a Continuous Dissociation Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010248. [PMID: 35010508 PMCID: PMC8750960 DOI: 10.3390/ijerph19010248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 05/04/2023]
Abstract
Objectives: Rapid Eye Movement Sleep Behaviour Disorder (RBD) is regarded as a prodrome of neurodegeneration, with a high conversion rate to α-synucleinopathies such as Parkinson's Disease (PD). The clinical diagnosis of RBD co-exists with evidence of REM Sleep Without Atonia (RSWA), a parasomnia that features loss of physiological muscular atonia during REM sleep. The objectives of this study are to implement an automatic detection of RSWA from polysomnographic traces, and to propose a continuous index (the Dissociation Index) to assess the level of dissociation between REM sleep stage and atonia. This is performed using Euclidean distance in proper vector spaces. Each subject is assigned a dissociation degree based on their distance from a reference, encompassing healthy subjects and clinically diagnosed RBD patients at the two extremes. Methods: Machine Learning models were employed to perform automatic identification of patients with RSWA through clinical polysomnographic scores, together with variables derived from electromyography. Proper distance metrics are proposed and tested to achieve a dissociation measure. Results: The method proved efficient in classifying RSWA vs. not-RSWA subjects, achieving an overall accuracy, sensitivity and precision of 87%, 93% and 87.5%, respectively. On its part, the Dissociation Index proved to be promising in measuring the impairment level of patients. Conclusions: The proposed method moves a step forward in the direction of automatically identifying REM sleep disorders and evaluating the impairment degree. We believe that this index may be correlated with the patients' neurodegeneration process; this assumption will undergo a robust clinical validation process involving healthy, RSWA, RBD and PD subjects.
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Affiliation(s)
- Irene Rechichi
- Department of Control and Computer Engineering, Politecnico di Torino, 10129 Turin, Italy;
- Correspondence: (I.R.); (A.C.)
| | - Antonella Iadarola
- Sleep Disorders Center, Department of Neuroscience, University of Turin, 10126 Turin, Italy;
| | - Maurizio Zibetti
- Department of Neuroscience, University of Turin, 10126 Turin, Italy;
| | - Alessandro Cicolin
- Sleep Disorders Center, Department of Neuroscience, University of Turin, 10126 Turin, Italy;
- Correspondence: (I.R.); (A.C.)
| | - Gabriella Olmo
- Department of Control and Computer Engineering, Politecnico di Torino, 10129 Turin, Italy;
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Schmidt MH, Dekkers MPJ, Baillieul S, Jendoubi J, Wulf MA, Wenz E, Fregolente L, Vorster A, Gnarra O, Bassetti CLA. Measuring Sleep, Wakefulness, and Circadian Functions in Neurologic Disorders. Sleep Med Clin 2021; 16:661-671. [PMID: 34711389 DOI: 10.1016/j.jsmc.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Neurologic disorders impact the ability of the brain to regulate sleep, wake, and circadian functions, including state generation, components of state (such as rapid eye movement sleep muscle atonia, state transitions) and electroencephalographic microarchitecture. At its most extreme, extensive brain damage may even prevent differentiation of sleep stages from wakefulness (eg, status dissociatus). Given that comorbid sleep-wake-circadian disorders are common and can adversely impact the occurrence, evolution, and management of underlying neurologic conditions, new technologies for long-term monitoring of neurologic patients may potentially usher in new diagnostic strategies and optimization of clinical management.
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Affiliation(s)
- Markus H Schmidt
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland; Ohio Sleep Medicine Institute, 4975 Bradenton Avenue, Dublin, OH 43017, USA.
| | - Martijn P J Dekkers
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland
| | - Sébastien Baillieul
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland; Univ. Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble 38000, France
| | - Jasmine Jendoubi
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland
| | - Marie-Angela Wulf
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland
| | - Elena Wenz
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland
| | - Livia Fregolente
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland
| | - Albrecht Vorster
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland
| | - Oriella Gnarra
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland; Sensory-Motor System Lab, IRIS, ETH Zurich, Switzerland
| | - Claudio L A Bassetti
- Department of Neurology, Bern University Hospital (Inselspital) and University Bern, Switzerland; Department of Neurology, University of Sechenow, Moscow, Russia
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13
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Piffer S, Cantalupo G, Filipponi S, Poretto V, Pellegrini M, Tanel R, Buganza M, Giometto B. Agrypnia excitata as the main feature in anti-leucine-rich glioma-inactivated 1 encephalitis: a detailed clinical and polysomnographic semiological analysis. Eur J Neurol 2021; 29:890-894. [PMID: 34679240 DOI: 10.1111/ene.15152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/09/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The core manifestations of leucine-rich glioma-inactivated 1 (LGI1) autoantibody-mediated encephalitis are limbic encephalitis and faciobrachial dystonic seizures. Agrypnia excitata (AE) is a rare syndrome characterized by sleep-wake cycle disruption, autonomic hyperactivation and episodes of oneiric stupor. Only a few diseases are known to present with AE. An autoimmune etiology must be considered when accompanied by neuromyotonia. A case of anti-LGI1 encephalitis presenting with AE is reported. METHODS Detailed clinical, video-polysomnographic, laboratory, radiological and long-term follow-up assessments were performed. RESULTS A previously healthy 58-year-old man was referred for a rapidly progressive change in mental status, characterized by persistent drowsiness and confusion, accompanied by frequent episodes of unconscious gestures ranging from simple stereotyped movements to more complex actions mimicking various daily activities. Other symptoms included tachycardia, hyperhidrosis, mild hyponatremia, rare faciobrachial dystonic seizures, and a single generalized tonic-clonic seizure, but no neuromyotonia. Prolonged video-polysomnography excluded epileptic activity and showed continuous monomorphic slowing of background activity not consistent with a regular wakefulness or sleep state. A brain magnetic resonance imaging scan was unremarkable. Brain fluorodeoxyglucose positron emission tomography revealed hypermetabolism of the hippocampi, amygdala and basal ganglia. Anti-LGI1 antibodies were detected in the cerebrospinal fluid. The sleep disorder resolved progressively after starting immunotherapy. CONCLUSIONS Agrypnia excitata can be a dominant, treatable manifestation of anti-LGI1 encephalitis. Oneiric stupor episodes are a useful clinical feature for establishing diagnostic suspicion and could provide a window to understanding the mechanisms behind some movement disorders in autoimmune encephalitis.
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Affiliation(s)
- Silvio Piffer
- Department of Emergency, Neurology Unit, Santa Chiara Hospital, Trento, Italy
| | | | - Stefania Filipponi
- Department of Emergency, Neurology Unit, Santa Chiara Hospital, Trento, Italy
| | - Valentina Poretto
- Department of Emergency, Neurology Unit, Santa Chiara Hospital, Trento, Italy
| | - Maria Pellegrini
- Department of Emergency, Neurology Unit, Santa Chiara Hospital, Trento, Italy
| | - Raffaella Tanel
- Department of Emergency, Neurology Unit, Santa Chiara Hospital, Trento, Italy
| | - Manuela Buganza
- Department of Emergency, Neurology Unit, Santa Chiara Hospital, Trento, Italy
| | - Bruno Giometto
- Department of Emergency, Neurology Unit, Santa Chiara Hospital, Trento, Italy
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14
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Cordani R, Veneruso M, Napoli F, Milanaccio C, Verrico A, Consales A, Cataldi M, Fava D, Di Iorgi N, Maghnie M, Mancardi MM, Nobili L. Sleep disturbances in craniopharyngioma: a challenging diagnosis. J Neurol 2021; 268:4362-4369. [PMID: 34522989 PMCID: PMC8439529 DOI: 10.1007/s00415-021-10794-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 12/12/2022]
Abstract
Craniopharyngiomas are rare solid or mixed solid and cystic tumors that arise from Rathke's pouch remnants along the pituitary-hypothalamic axis, from the sella turcica to the brain third ventricle. Both the tumor and its treatment can lead to significant neurological and endocrinological complications. Due to the essential role of the hypothalamus in the complex neurophysiologic process of sleep, tumors involving the hypothalamic area may be responsible for disturbances in sleep-wake regulation with alterations in the circadian rhythm, sleep fragmentation, and increased daytime sleepiness. We report two cases of patients with craniopharyngioma, who came to our attention due to the occurrence of episodes characterized by psychomotor slowing and afinalistic limb movements, temporal and spatial disorientation, psychomotor agitation, and oneiric stupor like episodes. A comprehensive clinical data collection and a targeted diagnostic work-up led to a diagnosis of severe sleep disorder characterized by hypersomnia, altered sleep-wake rhythm, and sleep-related breathing disorder. In addition, the polysomnography revealed peculiar alterations in the sleep structure. The diagnostic work-up lead to an accurate differential diagnosis between epileptic seizures and episodes expressions of sleep disturbances. These clinical features can be challenging to diagnose and can lead to misdiagnosis and inappropriate treatment. Diagnosis of sleep disorders is crucial, considering the impact of sleep on general health, cognition, and neuropsychological functioning. These findings support the need to incorporate a comprehensive sleep evaluation in childhood brain tumor involving the suprasellar/hypothalamic region.
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Affiliation(s)
- Ramona Cordani
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Marco Veneruso
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Flavia Napoli
- Department of Paediatrics, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | | | - Antonio Verrico
- Neuro-Oncology Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Alessandro Consales
- Paediatric Neurosurgery Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Matteo Cataldi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,Child Neuropsychiatry Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Daniela Fava
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Natascia Di Iorgi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,Department of Paediatrics, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | - Mohamad Maghnie
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.,Department of Paediatrics, IRCCS Giannina Gaslini Institute, Genoa, Italy
| | | | - Lino Nobili
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy. .,Child Neuropsychiatry Unit, IRCCS Giannina Gaslini Institute, Genoa, Italy.
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15
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Lividini A, Pizza F, Filardi M, Vandi S, Ingravallo F, Antelmi E, Bruni O, Cosentino FII, Ferri R, Guarnieri B, Marelli S, Ferini-Strambi L, Romigi A, Bonanni E, Maestri M, Terzaghi M, Manni R, Plazzi G. Narcolepsy type 1 features across the life span: age impact on clinical and polysomnographic phenotype. J Clin Sleep Med 2021; 17:1363-1370. [PMID: 33666167 DOI: 10.5664/jcsm.9198] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
STUDY OBJECTIVES Narcolepsy type 1 (NT1) is a chronic neurological disorder typically arising during adolescence and young adulthood. Recent studies demonstrated that NT1 presents with age-specific features, especially in children. With this study we aimed to describe and to compare the clinical pictures of NT1 in different age groups. METHODS In this cross-sectional, multicenter study, 106 untreated patients with NT1 enrolled at the time of diagnosis underwent clinical evaluation, a semistructured interview (including the Epworth Sleepiness Scale), nocturnal video-polysomnography, and the Multiple Sleep Latency Test. Patients were enrolled in order to establish 5 age-balanced groups (childhood, adolescence, adulthood, middle age, and senior). RESULTS The Epworth Sleepiness Scale score showed a significant increase with age, while self-reported diurnal total sleep time was lower in older and young adults, with the latter also complaining of automatic behaviors in more than 90% of patients. Children reported the cataplexy attacks to be more frequent (> 1/d in 95% of patients). "Recalling an emotional event," "meeting someone unexpectedly," "stress," and "anger" were more frequently reported in adult and older adult patients as possible triggers of cataplexy. Neurophysiological data showed a higher number of sleep-onset rapid eye movement periods on the Multiple Sleep Latency Test in adolescent compared to senior patients and an age-progressive decline in sleep efficiency. CONCLUSIONS Daytime sleepiness, cataplexy features and triggers, and nocturnal sleep structure showed age-related difference in patients with NT1; this variability may contribute to diagnostic delay and misdiagnosis.
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Affiliation(s)
- Althea Lividini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Marco Filardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Stefano Vandi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Francesca Ingravallo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Elena Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | | | - Raffaele Ferri
- Sleep Research Center, Department of Neurology IC, Oasi Research Institute-IRCCS, Troina, Italy
| | - Biancamaria Guarnieri
- Center of Sleep Medicine, Department of Neurology, Villa Serena Hospital and Villa Serena Foundation for Research, Città S. Angelo, Pescara, Italy
| | - Sara Marelli
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Neurology-Sleep Disorders Centre, Milan, Italy
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Neurology-Sleep Disorders Centre, Milan, Italy
| | - Andrea Romigi
- IRCCS Neuromed Istituto Neurologico Mediterraneo Sleep Medicine Centre, Pozzilli, Italy
| | - Enrica Bonanni
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Italy
| | - Michelangelo Maestri
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Italy
| | - Michele Terzaghi
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - Giuseppe Plazzi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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16
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Shambrook P, Hesters A, Marois C, Zemba D, Servan J, Gaymard B, Pico F, Delorme C, Lubetzki C, Arnulf I, Psimaras D, Honnorat J, Gales A, Méneret A. Delayed Benefit From Aggressive Immunotherapy in Waxing and Waning Anti-IgLON5 Disease. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/4/e1009. [PMID: 33986128 PMCID: PMC8192057 DOI: 10.1212/nxi.0000000000001009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/10/2021] [Indexed: 01/11/2023]
Affiliation(s)
- Pauline Shambrook
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Adèle Hesters
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Clémence Marois
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Daniel Zemba
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Jérôme Servan
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Bertrand Gaymard
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Fernando Pico
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Cécile Delorme
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Catherine Lubetzki
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Isabelle Arnulf
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Dimitri Psimaras
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Jérôme Honnorat
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Ana Gales
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France
| | - Aurélie Méneret
- From the Department of Neurology (P.S., A.H., C.M., C.D., C.L., A.M.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Neurology (D.Z., J.S., F.P.), Versailles Hospital, Le Chesnay, France; Department of Neurology (D.Z.), CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso; Department of Neurophysiology (B.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Sorbonne University (C.L., I.A., A.M.), Paris, France; Sleep Disorder Unit (I.A., A.G.), Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Service de Neurologie 2-Mazarin (D.P.), Groupe Hospitalier Pitié-Salpêtrière et Université Pierre et Marie Curie-Paris 6, AP-HP, Centre de Compétence des Syndromes Neurologiques Paranéoplasiques et Encéphalites Autoimmunes, Paris, France; French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.H.), Hospices Civils de Lyon, Institut NeuroMyoGene, INSERM U1217/CNRS UMR5310, Université de Lyon, Université Claude Bernard Lyon 1, France.
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17
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REM sleep behavior disorder: Mimics and variants. Sleep Med Rev 2021; 60:101515. [PMID: 34186416 DOI: 10.1016/j.smrv.2021.101515] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 11/22/2022]
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia with dream-enactment behaviors occurring during REM sleep and associated with the lack of the physiological REM sleep muscle atonia. It can be isolated and secondary to other neurological or medical conditions. Isolated RBD heralds in most cases a neurodegenerative condition due to an underlying synucleinopathy and consequently its recognition is crucial for prognostic implications. REM sleep without atonia on polysomnography is a mandatory diagnostic criterion. Different conditions may mimic RBD, the most frequent being obstructive sleep apnea during sleep, non-REM parasomnia, and sleep-related hypermotor epilepsy. These diseases might also be comorbid with RBD, challenging the evaluation of disease severity, the treatment choices and the response to treatment evaluation. Video-PSG is the gold standard for a correct diagnosis and will distinguish between different or comorbid sleep disorders. Careful history taking together with actigraphy may give important clues for the differential diagnosis. The extreme boundaries of RBD might also be seen in more severe and complex conditions like status dissociatus or in the sleep disorders' scenario of anti IgLON5 disease, but in the latter both clinical and neurophysiological features will differ. A step-by-step approach is suggested to guide the differential diagnosis.
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18
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Carrarini C, Russo M, Pagliaccio G, Dono F, Franciotti R, Deluca G, Nanni S, Saracino A, Onofrj M, Bonanni L. Visual evoked potential abnormalities in dementia with Lewy bodies. Neurophysiol Clin 2021; 51:425-431. [PMID: 33653623 DOI: 10.1016/j.neucli.2021.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Visuo-perceptual deficits and visual hallucinations (VHs) are common disturbances in patients with dementia with Lewy bodies (DLB) and those with Parkinson's disease (PD). In particular, delays in visual evoked potential (VEP), reversed by l-dopa administration, have previously been observed in PD patients. Impairment in metabolic functions of dopaminergic amacrine cells within the inner plexiform layer of the retina has been largely documented and has been posited as the underlying cause of visual and retinal alterations in PD. The aims of the present study were to investigate the presence of VEP abnormalities in DLB patients, as compared to a PD control group, and to assess the presence of significant correlations between neurophysiological measures and clinical symptoms (i.e., presence of visuospatial deficits and/or visual hallucinations). METHODS Fifteen DLB patients and fifteen matched PD patients underwent pattern reversal before and after l-dopa administration, and a short neuropsychological assessment. RESULTS In DLB patients, we observed delay of the P100 latency to foveal stimuli in both eyes compared to normative values. Compared to PD, DLB patients showed higher values of the P100 latency for foveal stimulation from the right eye prior to l-dopa administration (p = 0.018). No correlations between VEP alterations, visuo-spatial deficit and visual hallucinations were found. DISCUSSION Our findings demonstrated a longer P100 delay in DLB than in PD patients, especially along the right visual pathway. In contrast to previous studies, which focused on a dopaminergic pre-geniculate impairment of visual pathways, our evidence suggests that other mechanisms, possibly relying on thalamic involvement, which is known to be dysfunctional in DLB, can interfere with VEP abnormalities.
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Affiliation(s)
- Claudia Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | | | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Raffaella Franciotti
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Giulia Deluca
- Department of Neurology, SS Annunziata Hospital, Chieti, Italy
| | - Stefania Nanni
- Department of Neurology, SS Annunziata Hospital, Chieti, Italy
| | | | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy; Department of Neurology, SS Annunziata Hospital, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy; Department of Neurology, SS Annunziata Hospital, Chieti, Italy.
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19
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Gott J, Bovy L, Peters E, Tzioridou S, Meo S, Demirel Ç, Esfahani MJ, Oliveira PR, Houweling T, Orticoni A, Rademaker A, Booltink D, Varatheeswaran R, van Hooijdonk C, Chaabou M, Mangiaruga A, van den Berge E, Weber FD, Ritter S, Dresler M. Virtual reality training of lucid dreaming. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190697. [PMID: 33308070 PMCID: PMC7741087 DOI: 10.1098/rstb.2019.0697] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 01/18/2023] Open
Abstract
Metacognitive reflections on one's current state of mind are largely absent during dreaming. Lucid dreaming as the exception to this rule is a rare phenomenon; however, its occurrence can be facilitated through cognitive training. A central idea of respective training strategies is to regularly question one's phenomenal experience: is the currently experienced world real, or just a dream? Here, we tested if such lucid dreaming training can be enhanced with dream-like virtual reality (VR): over the course of four weeks, volunteers underwent lucid dreaming training in VR scenarios comprising dream-like elements, classical lucid dreaming training or no training. We found that VR-assisted training led to significantly stronger increases in lucid dreaming compared to the no-training condition. Eye signal-verified lucid dreams during polysomnography supported behavioural results. We discuss the potential mechanisms underlying these findings, in particular the role of synthetic dream-like experiences, incorporation of VR content in dream imagery serving as memory cues, and extended dissociative effects of VR session on subsequent experiences that might amplify lucid dreaming training during wakefulness. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.
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Affiliation(s)
- Jarrod Gott
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Leonore Bovy
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Emma Peters
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Sofia Tzioridou
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Psychology, Philipps University, Marburg, Germany
| | - Stefano Meo
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Çağatay Demirel
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mahdad Jafarzadeh Esfahani
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Pedro Reis Oliveira
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Thomas Houweling
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Anke Rademaker
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Diede Booltink
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Carmen van Hooijdonk
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Rivierduinen Institute for Mental Healthcare, Leiden, The Netherlands
| | - Mahmoud Chaabou
- Rivierduinen Institute for Mental Healthcare, Leiden, The Netherlands
| | | | - Erik van den Berge
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Frederik D. Weber
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Simone Ritter
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
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Irfan M, Schenck CH, Howell MJ. NonREM Disorders of Arousal and Related Parasomnias: an Updated Review. Neurotherapeutics 2021; 18:124-139. [PMID: 33527254 PMCID: PMC8116392 DOI: 10.1007/s13311-021-01011-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 12/14/2022] Open
Abstract
Parasomnias are abnormal behaviors and/or experiences emanating from or associated with sleep typically manifesting as motor movements of varying semiology. We discuss mainly nonrapid eye movement sleep and related parasomnias in this article. Sleepwalking (SW), sleep terrors (ST), confusional arousals, and related disorders result from an incomplete dissociation of wakefulness from nonrapid eye movement (NREM) sleep. Conditions that provoke repeated cortical arousals, and/or promote sleep inertia, lead to NREM parasomnias by impairing normal arousal mechanisms. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking disorders. Sleep-related eating disorder (SRED) is characterized by a disruption of the nocturnal fast with episodes of feeding after arousal from sleep. SRED is often associated with the use of sedative-hypnotic medications, in particular the widely prescribed benzodiazepine receptor agonists. Compelling evidence suggests that nocturnal eating may in some cases be another nonmotor manifestation of Restless Legs Syndrome (RLS). Initial management should focus upon decreasing the potential for sleep-related injury followed by treating comorbid sleep disorders and eliminating incriminating drugs. Sexsomnia is a subtype of disorders of arousal, where sexual behavior emerges from partial arousal from nonREM sleep. Overlap parasomnia disorders consist of abnormal sleep-related behavior both in nonREM and REM sleep. Status dissociatus is referred to as a breakdown of the sleep architecture where an admixture of various sleep state markers is seen without any specific demarcation. Benzodiazepine therapy can be effective in controlling SW, ST, and sexsomnia, but not SRED. Paroxetine has been reported to provide benefit in some cases of ST. Topiramate, pramipexole, and sertraline can be effective in SRED. Pharmacotherapy for other parasomnias continues to be less certain, necessitating further investigation. NREM parasomnias may resolve spontaneously but require a review of priming and predisposing factors.
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Affiliation(s)
- Muna Irfan
- Department of Neurology, Minneapolis Veterans Affairs Medical Center/ Pulmonary allergy, Critical Care and Sleep, University of Minnesota, Minneapolis, MN USA
| | - Carlos H. Schenck
- Department of Psychiatry, Hennepin Health Care, University of Minnesota, Minneapolis, MN USA
| | - Michael J Howell
- Department of Neurology, Sleep Disorders Center, University of Minnesota Medical Center, Minneapolis, MN USA
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21
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Liu X, Yang L, Han Y, Xu J, Pang Z, Du Y, Feng Y, Lin Y. Electrophysiological Evaluation in Identifying Unique Sleep Features Among Anti-LGI1 Encephalitis Patients During Active and Recovery Phase. Nat Sci Sleep 2021; 13:527-536. [PMID: 33976578 PMCID: PMC8104977 DOI: 10.2147/nss.s299467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/31/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The purpose of this study was to illustrate the electrophysiological features of sleep disturbances in patients with anti-leucine-rich glioma-inactivated protein 1 (anti-LGI1) encephalitis in both active and recovery stages. METHODS Retrospectively filed video electroencephalogram (VEEG) and polysomnography (PSG) data in 24 patients with anti-LGI1 encephalitis were analyzed in comparison with that in 20 individuals without sleep disorders as control group. RESULTS Sleep efficiency (SE) and total sleep time involving REM and NREM sleep were significantly decreased in patients with anti-LGI1 encephalitis during the active stage compared to that during the recovery stage and in the control group. Imbalanced sleep structure was found, demonstrated by elevated N1, decreased N3 and REM components, as well as abnormal N2 structure characterized with significantly lower spindle duration and density during the active stage. These findings were independent of the presence of nocturnal episodic events or sleep hyperkinetic movements (HMs). HMs were present in 11/23 patients throughout NREM and REM sleep (nonspecific in sleep stages) during the active stage. During the recovery stage, SE and sleep structures were dramatically improved, including the percentage of N3 and REM sleep, spindle duration and density. Ten of 11 patients with HMs were followed up. HMs were totally remitted in 3 patients and still persistent in 1, while evolved into REM sleep behavior disorder (RBD) in 4 with comorbid periodic limb movement syndrome (PLMS) in 3/4, and only PLMS in 2. CONCLUSION Sleep disturbances were remarkable and intrinsic features in active anti-LGI1 encephalitis, marked by overall disruptions of both NREM and REM sleep, as well as the presence of HMs, which tend to evolve into RBD or PLMS during the recovery stage. Long-term follow-up with PSG is needed, especially for those patients with severe sleep disturbances during the active phase.
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Affiliation(s)
- Xiaoyun Liu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
| | - Liling Yang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
| | - Yuxiang Han
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
| | - Jingjing Xu
- Department of Geriatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
| | - Zaiying Pang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
| | - Yabo Feng
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
| | - Youting Lin
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, 250021, People's Republic of China
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22
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Wood C, Bianchi MT, Yun CH, Shin C, Thomas RJ. Multicomponent Analysis of Sleep Using Electrocortical, Respiratory, Autonomic and Hemodynamic Signals Reveals Distinct Features of Stable and Unstable NREM and REM Sleep. Front Physiol 2020; 11:592978. [PMID: 33343390 PMCID: PMC7744633 DOI: 10.3389/fphys.2020.592978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/13/2020] [Indexed: 12/05/2022] Open
Abstract
A new concept of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep is proposed, that of multi-component integrative states that define stable and unstable sleep, respectively, NREMS, NREMUS REMS, and REMUS. Three complementary data sets are used: obstructive sleep apnea (20), healthy subjects (11), and high loop gain sleep apnea (50). We use polysomnography (PSG) with beat-to-beat blood pressure monitoring, and electrocardiogram (ECG)-derived cardiopulmonary coupling (CPC) analysis to demonstrate a bimodal, rather than graded, characteristic of NREM sleep. Stable NREM (NREMS) is characterized by high probability of occurrence of the <1 Hz slow oscillation, high delta power, stable breathing, blood pressure dipping, strong sinus arrhythmia and vagal dominance, and high frequency CPC. Conversely, unstable NREM (NREMUS) has the opposite features: a fragmented and discontinuous <1 Hz slow oscillation, non-dipping of blood pressure, unstable respiration, cyclic variation in heart rate, and low frequency CPC. The dimension of NREM stability raises the possibility of a comprehensive integrated multicomponent network model of NREM sleep which captures sleep onset (e.g., ventrolateral preoptic area-based sleep switch) processes, synaptic homeostatic delta power kinetics, and the interaction of global and local sleep processes as reflected in the spatiotemporal evolution of cortical “UP” and “DOWN” states, while incorporating the complex dynamics of autonomic-respiratory-hemodynamic systems during sleep. Bimodality of REM sleep is harder to discern in health. However, individuals with combined obstructive and central sleep apnea allows ready recognition of REMS and REMUS (stable and unstable REM sleep, respectively), especially when there is a discordance of respiratory patterns in relation to conventional stage of sleep.
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Affiliation(s)
- Christopher Wood
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Matt Travis Bianchi
- Division of Sleep Medicine, Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Chol Shin
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Robert Joseph Thomas
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
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23
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Garay A, Giardino DL, Huck-Iriart C, Blanco S, Reder AT. The rhythms of AMBEs (arousal-related motor behavioral episodes) in Agrypnia Excitata: a video motor analysis. Sleep Med 2020; 74:224-226. [PMID: 32861014 DOI: 10.1016/j.sleep.2020.06.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/17/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Arturo Garay
- Medicina del Sueño-Neurología-Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC), Ciudad de Buenos Aires, Argentina.
| | - Daniela L Giardino
- Medicina del Sueño-Neurología-Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" (CEMIC), Ciudad de Buenos Aires, Argentina
| | - Cristián Huck-Iriart
- Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín (UNSAM), Buenos Aires, Argentina
| | - Susana Blanco
- Instituto Nacional del Cáncer - CONICET, Ciudad de Buenos Aires, Argentina
| | - Anthony T Reder
- Department of Neurology, University of Chicago, Chicago, IL, USA
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24
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Lin N, Hao H, Guan H, Sun H, Liu Q, Lu Q, Jin L, Ren H, Huang Y. Sleep Disorders in Leucine-Rich Glioma-Inactivated Protein 1 and Contactin Protein-Like 2 Antibody-Associated Diseases. Front Neurol 2020; 11:696. [PMID: 32849186 PMCID: PMC7406672 DOI: 10.3389/fneur.2020.00696] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/09/2020] [Indexed: 01/12/2023] Open
Abstract
Objective: Sleep disorders are common in voltage-gated potassium channel complex antibody (VGKC-Ab) diseases. The aim was to investigate the sleep disturbances and polysomnography (PSG) characteristics in patients with VGKC-Ab-associated diseases. Methods: Twenty-seven patients with leucine-rich glioma-inactivated protein 1 antibody (LGI1-Ab) encephalitis, seven patients with contactin protein-like 2 antibody (Caspr2-Ab)-associated diseases, and 14 healthy controls with at least one PSG or actigraphy recording were recruited at Peking Union Medical College Hospital from January 2014 to July 2019. Results: Sleep disorders including insomnia, hypersomnia, rapid eye movement (REM) sleep behavior disorder (RBD), periodic limb movements in sleep (PLMS), agrypnia excitata, and obstructive sleep apnea syndrome were observed. Twenty-one PSG recordings from patients with LGI1-Ab encephalitis demonstrated a decrease in total sleep time (TST) (median 365.5, range 184.5-495.5 min), sleep efficiency (70.0%, 47-92%), N3 sleep (9.7%, 0-32.9%), and REM sleep (9.9%, 0.4-27.9%). Of five patients with Caspr2-Ab-associated diseases, TST was found to be 329.5 (167.0-377.5 min), and sleep efficiency was found to be 61.7% (34.6-71.7%). The percentage for N3 and REM sleep was found to be 15.0% (0-34.6%) and 12.7% (0-22.2%), respectively. Both RBD and PLMS were observed more frequently in patients with LGI1-Ab encephalitis. We identified status dissociatus (SD) in five (23.8%) patients with LGI1-Ab encephalitis and two (40%) patients with Caspr2-Ab diseases. The former is more likely to have simple limb movements rather than complex movements, which mimic the contents of their dreams. Continuous insomnia was more common in patients with Caspr2-Ab diseases than patients with LGI1-Ab encephalitis. Patients reported clinical and PSG improvements following immunotherapy. Conclusion: Sleep disorders in patients with VGKC-Ab-associated diseases include decreased TST and poor sleep efficiency. Our studies provide evidence of SD in patients with LGI1-Ab encephalitis.
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Affiliation(s)
- Nan Lin
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Honglin Hao
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Hongzhi Guan
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Heyang Sun
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Qing Liu
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Qiang Lu
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Liri Jin
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Haitao Ren
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Yan Huang
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
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25
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Gaig C, Iranzo A, Cajochen C, Vilaseca I, Embid C, Dalmau J, Graus F, Santamaria J. Characterization of the sleep disorder of anti-IgLON5 disease. Sleep 2020; 42:5519031. [PMID: 31198936 DOI: 10.1093/sleep/zsz133] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/08/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVE To characterize the sleep disorder of anti-IgLON5 disease. METHODS We reviewed 27 video-polysomnographies (V-PSG), 6 multiple sleep latency tests (MSLT), 2 videsomnoscopies with dexmedetomidine, and 10 actigraphies recorded during the disease course of five patients. Due to severe sleep architecture abnormalities, we used a novel modified sleep scoring system combining conventional stages with a descriptive approach in which two additional stages were identified: undifferentiated-NREM (UN-NREM) and poorly structured N2 (P-SN2) sleep that were characterized by abnormal motor activation and absence or sparse elements of conventional NREM sleep. RESULTS Sleep-related vocalizations, movements, behaviors, and respiratory abnormalities were reported by bed-partners. In all patients, NREM sleep onset and sleep reentering after an awakening occurred as UN-NREM (median: 29.8% of total sleep time [TST]) and P-SN2 sleep (14.5% TST) associated with vocalizations and simple and quasi-purposeful movements. Sleep initiation was normalized in one patient with a high dose of steroids, but NREM sleep abnormalities reappeared in subsequent V-PSG. In all patients, if sleep continued uninterrupted, there was a progressive normalization with normal N2 (11.7% TST) and N3 (22.3% TST) sleep but stridor and obstructive apnea emerged. REM sleep behavior disorder (RBD) occurred in four patients. Sleep initiation was also altered in MSLT and dexmedetomidine-induced sleep. Actigraphy showed a 10-fold increase of nocturnal activity compared with controls. Sleep abnormalities remained stable during the disease. CONCLUSIONS The sleep disorder of anti-IgLON5 disease presents as a complex sleep pattern characterized by abnormal sleep initiation with undifferentiated NREM sleep, RBD, periods of normal NREM sleep, stridor, and obstructive apnea.
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Affiliation(s)
- Carles Gaig
- Neurology Service, Hospital Clínic of Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alex Iranzo
- Neurology Service, Hospital Clínic of Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Switzerland
| | - Isabel Vilaseca
- Multidisciplinary Sleep Unit, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Ear Nose and Throat, Hospital Clinic, Barcelona, Spain
| | - Cristina Embid
- Multidisciplinary Sleep Unit, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Respiratory Diseases, Hospital Clinic, Barcelona, Spain
| | - Josep Dalmau
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Francesc Graus
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Joan Santamaria
- Neurology Service, Hospital Clínic of Barcelona, Barcelona, Spain.,Multidisciplinary Sleep Unit, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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O'Dowd S, Schumacher J, Burn DJ, Bonanni L, Onofrj M, Thomas A, Taylor JP. Fluctuating cognition in the Lewy body dementias. Brain 2020; 142:3338-3350. [PMID: 31411317 DOI: 10.1093/brain/awz235] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/28/2019] [Accepted: 06/09/2019] [Indexed: 01/17/2023] Open
Abstract
Fluctuating cognition is a core diagnostic feature of dementia with Lewy bodies and is also a key clinical feature of Parkinson's disease dementia. These dementias share common pathological features and are referred to as Lewy body dementias. Whilst highly prevalent in Lewy body dementia, with up to 90% of patients experiencing the symptom at some point in the disease trajectory, clinical identification of fluctuating cognition is often challenging. Furthermore, its underlying pathophysiological processes remain unclear. However, neuroimaging and neurophysiological techniques have recently provided insight into potential drivers of the phenomenon. In this update, we review data pertaining to clinical features and underlying mechanisms of fluctuating cognition in Lewy body dementia. We collate evidence for different proposed aetiologies: fluctuating cognition as an attentional disorder, as a consequence of loss of cholinergic drive, as a manifestation of failure in neuronal efficiency and synchrony, and as a disorder of sleep/arousal. We also review data relating to putative mechanisms that have received less attention to date. Increased understanding of fluctuating cognition may help to illuminate pathophysiological mechanisms in cognitive processing in Lewy body dementia, guide future research, and facilitate the design of targeted therapeutic approaches.
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Affiliation(s)
- Seán O'Dowd
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK.,Department of Neurology, Tallaght University Hospital, Dublin 24, Ireland; Academic Unit of Neurology, Trinity College Dublin, Ireland
| | - Julia Schumacher
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - David J Burn
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Science and Aging Research Centre, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Science and Aging Research Centre, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Alan Thomas
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
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Franciotti R, Pilotto A, Moretti DV, Falasca NW, Arnaldi D, Taylor JP, Nobili F, Kramberger M, Ptacek SG, Padovani A, Aarlsand D, Onofrj M, Bonanni L. Anterior EEG slowing in dementia with Lewy bodies: a multicenter European cohort study. Neurobiol Aging 2020; 93:55-60. [PMID: 32450445 DOI: 10.1016/j.neurobiolaging.2020.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 02/08/2023]
Abstract
Electroencephalography (EEG) slowing with prealpha dominant frequency (DF) in posterior derivations is a biomarker for dementia with Lewy bodies (DLB) diagnosis, in contrast with Alzheimer's disease (AD). However, an intrasubject re-evaluation of the original data, which contributed to the identification of EEG DLB biomarker, showed that DF was slower in anterior than posterior derivations. We suppose this anterior-posterior gradient of DF slowing could arise in DLB from a thalamocortical dysrhythmia, differently involving the anterior and posterior cortical areas, and correlating with cognitive impairment (Mini-Mental State Examination). EEG was recorded in 144 DLB, 116 AD, and 65 controls from 7 Centers of the European DLB Consortium. Spectra were divided into delta, theta, prealpha, alpha frequency bands. In DLB, mean DF was prealpha both anteriorly and posteriorly, but lower anteriorly (p < 0.001). In 14% of DLB, DF was prealpha anteriorly, whereas alpha posteriorly. In AD and controls, DF was constantly alpha. EEG slowing in DLB correlated with cognitive impairment. Thalamocortical dysrhythmia gives rise to prealpha rhythm with an anterior-posterior gradient and correlates with impaired cognition.
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Affiliation(s)
- Raffaella Franciotti
- Department of Neuroscience, Imaging and Clinical Science, and Aging Research Centre, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Davide V Moretti
- Alzheimer's Epidemiology and Rehabilitation in Alzheimer's Disease Operative Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Walter Falasca
- Department of Neuroscience, Imaging and Clinical Science, and Aging Research Centre, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - John-Paul Taylor
- Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Milica Kramberger
- Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Sara Garcia Ptacek
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, and Memory Clinic Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Science, and Aging Research Centre, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Science, and Aging Research Centre, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy.
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Liu X, Han Y, Yang L, Wang B, Shao S, Feng Y, Pang Z, Du Y, Lin Y. The exploration of the spectrum of motor manifestations of anti-LGI1 encephalitis beyond FBDS. Seizure 2020; 76:22-27. [PMID: 31972532 DOI: 10.1016/j.seizure.2019.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/21/2019] [Accepted: 12/22/2019] [Indexed: 01/14/2023] Open
Abstract
PURPOSE The purpose of this study was to characterize the spectrum of motor events in patients with acute anti-leucine-rich glioma-inactivated protein 1 (anti-LGI1) encephalitis through video-electroencephalogram (VEEG) recordings. METHOD We collected data retrospectively from 16 patients diagnosed with anti-LGI1 encephalitis who had completed VEEG recording during hospitalization. RESULTS VEEG monitoring lasted a median of 11.0 h (range 4.5∼20). Fourteen types of seizures were recorded in 9 patients (56.3 %). Eight of the 14 types of seizures demonstrated typical ictal EEG evolution (including 2 subclinical seizures), 3/14 demonstrated EEG electrodecremental events (EDE) at onset but without further evolution, and 3/14 could be only judged by analyzing semiology. FBDS was recorded in 6 patients (37.5 %), and all these attacks were followed by epileptic seizures. Simple hyperkinetic movements (HMs), such as jerk-like or twisting movements, were found in 8 (50 %) patients, and 6 of them had complex HMs, such as manipulating movements or mimics of daily activities, during sleep. CONCLUSIONS 1. Atypical seizures, for instance, seizures without EEG evolution, are not rare but likely to be overlooked. 2. FBDS is closely linked with epileptic seizures, revealing FBDS to be a part of epileptic attacks. 3. HMs could expand the spectrum of motor manifestations, overlapping with sleep disorders. 4. The high prevalence of these motor events might be due to the disrupted cortical-subcortical network, which is critical in motor control and sleep.
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Affiliation(s)
- Xiaoyun Liu
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Yuxiang Han
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Liling Yang
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Bao Wang
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China; Shandong Medical Imaging Research Institue, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Sai Shao
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China; Shandong Medical Imaging Research Institue, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Yabo Feng
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Zaiying Pang
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Yifeng Du
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China
| | - Youting Lin
- Shandong Provincial Hospital Affiliated to Shandong University, Department of Neurology, No 324, Jingwu Road, Huaiyin Zone, Jinan City, Shandong Province, 250012, PR China.
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Sleep and neurological autoimmune diseases. Neuropsychopharmacology 2020; 45:129-140. [PMID: 31302665 PMCID: PMC6879573 DOI: 10.1038/s41386-019-0463-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 06/17/2019] [Accepted: 07/02/2019] [Indexed: 12/17/2022]
Abstract
Neurological autoimmune diseases are characterized by an inappropriate immune response that by mistake targets the nervous system. As a result, patients experiment a number of neurological manifestations that may include insomnia, excessive daytime sleepiness, cataplexy, central hypoventilation, and REM sleep behavior disorder. Polysomnographic evaluation may reveal disorganized sleep architecture involving both NREM and REM sleep, and REM sleep intrusions into wakefulness. The study of sleep disorders in the setting of autoimmune diseases (e.g., narcolepsy, anti-IgLON5 disease, paraneoplastic neurological syndromes) shows that an abnormal immune-mediated (humoral or cellular) response target the neuronal structures (e.g., brainstem, hypothalamus) and neurotransmitters systems (e.g., hypocretin) that regulate sleep resulting in sleep impairment. It is a window to examine the link between the autoimmune system and the sleep regulation at the molecular, cellular, and anatomic level.
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30
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REM sleep behavior disorder in narcolepsy: A secondary form or an intrinsic feature? Sleep Med Rev 2019; 50:101254. [PMID: 31931470 DOI: 10.1016/j.smrv.2019.101254] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/09/2019] [Accepted: 12/09/2019] [Indexed: 01/17/2023]
Abstract
Disrupted nighttime sleep is one of the pentad of symptoms defining Narcolepsy. REM sleep behavior disorder (RBD) largely contributes to night sleep disruption and narcolepsy is the most common cause of secondary RBD. However, RBD linked to narcolepsy (N-RBD) has been insufficiently characterized, leaving unsolved a number of issues. Indeed, it is still debated whether N-RBD is an intrinsic feature of narcolepsy, as indubitable for cataplexy, and therefore strictly linked to the cerebrospinal fluid hypocretin-1 (CSF hcrt-1) deficiency, or an associated feature, with a still unclear pathophysiology. The current review aims at rendering a comprehensive state-of-the-art of N-RBD, highlighting the open and unsettled topics. RBD reportedly affects 30-60% of patients with Narcolepsy type 1 (NT1), but it may be seen also in Narcolepsy type 2 (NT2). When compared to idiopathic/isolated RBD (iRBD), N-RBD has been reported to be characterized by less energetic and quieter episode, which however occur with the same probability in the first and the second part of the night and sometime even subcontinuously. N-RBD patients are generally younger than those with iRBD. N-RBD has been putatively linked to wake-sleep instability due to CSF hcrt-1 deficiency, but this latter by itself cannot explain completely the phenomenon as N-RBD has not been universally linked to low CSF hcrt-1 levels and it may be observed also in NT2. Therefore, other factors may probably play a role and further studies are needed to clarify this issue. In addition, therapeutic options have been poorly investigated.
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31
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Status dissociatus: the most extreme expression of state dissociation. NEUROLOGÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.nrleng.2019.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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32
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Dauvilliers Y, Schenck CH, Postuma RB, Iranzo A, Luppi PH, Plazzi G, Montplaisir J, Boeve B. REM sleep behaviour disorder. Nat Rev Dis Primers 2018; 4:19. [PMID: 30166532 DOI: 10.1038/s41572-018-0016-5] [Citation(s) in RCA: 243] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia that is characterized by loss of muscle atonia during REM sleep (known as REM sleep without atonia, or RSWA) and abnormal behaviours occurring during REM sleep, often as dream enactments that can cause injury. RBD is categorized as either idiopathic RBD or symptomatic (also known as secondary) RBD; the latter is associated with antidepressant use or with neurological diseases, especially α-synucleinopathies (such as Parkinson disease, dementia with Lewy bodies and multiple system atrophy) but also narcolepsy type 1. A clinical history of dream enactment or complex motor behaviours together with the presence of muscle activity during REM sleep confirmed by video polysomnography are mandatory for a definite RBD diagnosis. Management involves clonazepam and/or melatonin and counselling and aims to suppress unpleasant dreams and behaviours and improve bedpartner quality of life. RSWA and RBD are now recognized as manifestations of an α-synucleinopathy; most older adults with idiopathic RBD will eventually develop an overt neurodegenerative syndrome. In the future, studies will likely evaluate neuroprotective therapies in patients with idiopathic RBD to prevent or delay α-synucleinopathy-related motor and cognitive decline.
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Affiliation(s)
- Yves Dauvilliers
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac Montpellier, Montpellier, France. .,INSERM, U1061, Montpellier, France, Université Montpellier, Montpellier, France.
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, and Departments of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ronald B Postuma
- Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada
| | - Alex Iranzo
- Neurology Service, Multidisciplinary Sleep Unit, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Pierre-Herve Luppi
- UMR 5292 CNRS/U1028 INSERM, Center of Research in Neuroscience of Lyon (CRNL), SLEEP Team, Université Claude Bernard Lyon I, Faculté de Médecine RTH Laennec, Lyon, France
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS, Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Jacques Montplaisir
- Department of Psychiatry, Université de Montréal, Québec, Canada and Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada
| | - Bradley Boeve
- Department of Neurology and Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA
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Otheman Y, Satté A, Mounach J, Kadiri M, Bichra MZ. [Sleep related dissociative disorder: A case complicated by a suicide attempt]. Encephale 2018; 45:271-273. [PMID: 29983174 DOI: 10.1016/j.encep.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/10/2018] [Accepted: 06/13/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Y Otheman
- Service de psychiatrie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc.
| | - A Satté
- Service de neurophysiologie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
| | - J Mounach
- Service de neurophysiologie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
| | - M Kadiri
- Service de psychiatrie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
| | - M Z Bichra
- Service de psychiatrie, hôpital militaire d'instruction Mohammed-V Hay Ryad, Rabat, Maroc
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Breen DP, Högl B, Fasano A, Trenkwalder C, Lang AE. Sleep-related motor and behavioral disorders: Recent advances and new entities. Mov Disord 2018; 33:1042-1055. [PMID: 29756278 DOI: 10.1002/mds.27375] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 12/30/2022] Open
Abstract
Patients with sleep-related motor and behavioral disorders present to a variety of subspecialty clinics (neurology, sleep medicine, respiratory medicine, psychiatry). Diagnosing these disorders can be difficult, and sometimes they have a significant impact on quality of life. Alongside a number of common and well-recognized conditions, several new disease entities have been described in recent years that present with abnormal nocturnal motor phenomena (such as ADCY5-associated disease and anti-IgLON5 disease). Our understanding of the neural basis and prognostic significance of other sleep-related disorders has also grown, particularly rapid eye movement sleep behavior disorder. This review (along with a collection of previously unpublished videos) is intended to aid in the recognition and treatment of these patients. The recent change in terminology from nocturnal frontal lobe epilepsy to sleep-related hypermotor epilepsy is also discussed. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- David P Breen
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Canada
| | - Claudia Trenkwalder
- Centre of Parkinsonism and Movement Disorders, Paracelsus-Elena Hospital, Kassel, Germany.,Department of Neurosurgery, University Medical Center, Göttingen, Germany
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Canada
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Irfan M, Schenck CH, Howell MJ. Non-Rapid Eye Movement Sleep and Overlap Parasomnias. Continuum (Minneap Minn) 2017; 23:1035-1050. [PMID: 28777175 DOI: 10.1212/con.0000000000000503] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article reviews the spectrum of non-rapid eye movement (non-REM) sleep parasomnias, including sleepwalking, confusional arousals, and sleep terrors, which represent the range of phenotypic disorders of arousal from non-REM sleep that occurs in children and adults. RECENT FINDINGS The International Classification of Sleep Disorders, Third Edition (ICSD-3) classifies parasomnias according to the sleep stage they emerge from: REM, non-REM, or other. Demographics, clinical features, and diagnosis of non-REM parasomnias are reviewed in this article, and an up-to-date synopsis of guidelines for management strategies to assist in the treatment of these sleep disorders is provided. SUMMARY The non-REM parasomnias are most common in children and adolescents but may persist into adulthood. They can be distinguishable from REM parasomnias and nocturnal epilepsies, and, importantly, may lead to injury. Additionally, other parasomnias in this spectrum include sleep-related eating disorder and sexsomnia. Overlap parasomnia disorder includes one or more manifestations of a non-REM parasomnia seen in combination with REM sleep behavior disorder, representing an apparent erosion of the normally distinct stages of non-REM and REM sleep. A similar yet much more extreme dissociation of states underlies agrypnia excitata and status dissociatus, which represent rare, severe dissociations between non-REM, REM, and wake states resulting clinically in oneiric behaviors and severe derangement of normal polysomnographic wake and sleep stage characteristics. Management of non-REM and overlap parasomnias and state dissociation disorders include ensuring bedroom safety and prescription of clonazepam or hypnosis, in select cases, although in children and adolescents with noninjurious behaviors, non-REM parasomnias are often age-limited developmental disorders, which may ultimately remit by adulthood, and, in these cases, counseling and education alone may suffice. Timely and accurate recognition of the non-REM and overlap parasomnias is crucial to limiting potential patient injury.
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Antelmi E, Pizza F, Vandi S, Neccia G, Ferri R, Bruni O, Filardi M, Cantalupo G, Liguori R, Plazzi G. The spectrum of REM sleep-related episodes in children with type 1 narcolepsy. Brain 2017; 140:1669-1679. [PMID: 28472332 DOI: 10.1093/brain/awx096] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 02/26/2017] [Indexed: 11/14/2022] Open
Abstract
Type 1 narcolepsy is a central hypersomnia due to the loss of hypocretin-producing neurons and characterized by cataplexy, excessive daytime sleepiness, sleep paralysis, hypnagogic hallucinations and disturbed nocturnal sleep. In children, close to the disease onset, type 1 narcolepsy has peculiar clinical features with severe cataplexy and a complex admixture of movement disorders occurring while awake. Motor dyscontrol during sleep has never been systematically investigated. Suspecting that abnormal motor control might affect also sleep, we systematically analysed motor events recorded by means of video polysomnography in 40 children with type 1 narcolepsy (20 females; mean age 11.8 ± 2.6 years) and compared these data with those recorded in 22 age- and sex-matched healthy controls. Motor events were classified as elementary movements, if brief and non-purposeful and complex behaviours, if simulating purposeful behaviours. Complex behaviours occurring during REM sleep were further classified as 'classically-defined' and 'pantomime-like' REM sleep behaviour disorder episodes, based on their duration and on their pattern (i.e. brief and vivid-energetic in the first case, longer and with subcontinuous gesturing mimicking daily life activity in the second case). Elementary movements emerging either from non-REM or REM sleep were present in both groups, even if those emerging from REM sleep were more numerous in the group of patients. Conversely, complex behaviours could be detected only in children with type 1 narcolepsy and were observed in 13 patients, with six having 'classically-defined' REM sleep behaviour disorder episodes and seven having 'pantomime-like' REM sleep behaviour disorder episodes. Complex behaviours during REM sleep tended to recur in a stereotyped fashion for several times during the night, up to be almost continuous. Patients displaying a more severe motor dyscontrol during REM sleep had also more severe motor disorder during daytime (i.e. status cataplecticus) and more complaints of disrupted nocturnal sleep and of excessive daytime sleepiness. The neurophysiological hallmark of this severe motor dyscontrol during REM sleep was a decreased atonia index. The present study reports for the first time the occurrence of a severe and peculiar motor disorder during REM sleep in paediatric type 1 narcolepsy and confirms the presence of a severe motor dyscontrol in these patients, emerging not only from wakefulness (i.e. status cataplecticus), but also from sleep (i.e. complex behaviours during REM sleep). This is probably related to the acute imbalance of the hypocretinergic system, which physiologically acts by promoting movements during wakefulness and suppressing them during sleep.
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Affiliation(s)
- Elena Antelmi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,IRCSS, Institute of Neurological Sciences, Bologna, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,IRCSS, Institute of Neurological Sciences, Bologna, Italy
| | - Stefano Vandi
- IRCSS, Institute of Neurological Sciences, Bologna, Italy
| | - Giulia Neccia
- IRCSS, Institute of Neurological Sciences, Bologna, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology, I.C., Oasi Institute (IRCCS), Troina, Italy
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, University of Rome La Sapienza, Rome, Italy
| | - Marco Filardi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Gaetano Cantalupo
- Child Neuropsychiatry, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,IRCSS, Institute of Neurological Sciences, Bologna, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,IRCSS, Institute of Neurological Sciences, Bologna, Italy
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Miró-Andreu A, López-Bernabé R, Garnés Sánchez MC, Maeztu Sardiña MC. Status dissociatus: The most extreme expression of state dissociation. Neurologia 2017; 34:209-211. [PMID: 28712838 DOI: 10.1016/j.nrl.2017.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/03/2017] [Accepted: 05/11/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- A Miró-Andreu
- Servicio de Neurofisiología, Hospital General Universitario Reina Sofía, Murcia, España.
| | - R López-Bernabé
- Servicio de Neurofisiología, Hospital General Universitario Morales Meseguer, Murcia, España
| | - M C Garnés Sánchez
- Servicio de Neurofisiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - M C Maeztu Sardiña
- Servicio de Neurofisiología, Hospital General Universitario Reina Sofía, Murcia, España
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38
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Onofrj M, Carrozzino D, D’Amico A, Di Giacomo R, Delli Pizzi S, Thomas A, Onofrj V, Taylor JP, Bonanni L. Psychosis in parkinsonism: an unorthodox approach. Neuropsychiatr Dis Treat 2017; 13:1313-1330. [PMID: 28553118 PMCID: PMC5439966 DOI: 10.2147/ndt.s116116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Psychosis in Parkinson's disease (PD) is currently considered as the occurrence of hallucinations and delusions. The historical meaning of the term psychosis was, however, broader, encompassing a disorganization of both consciousness and personality, including behavior abnormalities, such as impulsive overactivity and catatonia, in complete definitions by the International Classification of Diseases-10 (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Our review is aimed at reminding that complex psychotic symptoms, including impulsive overactivity and somatoform disorders (the last being a recent controversial entity in PD), were carefully described in postencephalitic parkinsonism (PEP), many decades before dopaminergic treatment era, and are now described in other parkinsonisms than PD. Eminent neuropsychiatrists of the past century speculated that studying psychosis in PEP might highlight its mechanisms in other conditions. Yet, functional assessments were unavailable at the time. Therefore, the second part of our article reviews the studies of neural correlates of psychosis in parkinsonisms, by taking into account both theories on the narrative functions of the default mode network (DMN) and hypotheses on DMN modulation.
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Affiliation(s)
- Marco Onofrj
- Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara
- CE.S.I. University Foundation
| | - Danilo Carrozzino
- Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
| | - Aurelio D’Amico
- Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara
- CE.S.I. University Foundation
| | - Roberta Di Giacomo
- Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara
- CE.S.I. University Foundation
| | - Stefano Delli Pizzi
- Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara
| | - Astrid Thomas
- Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara
- CE.S.I. University Foundation
| | - Valeria Onofrj
- Department of Bioimaging, University Cattolica del Sacro Cuore, Rome, Italy
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Ageing and Vitality Newcastle University Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Laura Bonanni
- Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara
- CE.S.I. University Foundation
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Walker RH. Automatic behavior and communication due to pramipexole. JOURNAL OF CLINICAL MOVEMENT DISORDERS 2016; 3:9. [PMID: 27403333 PMCID: PMC4939520 DOI: 10.1186/s40734-016-0038-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 06/11/2016] [Indexed: 11/25/2022]
Abstract
A 45–year-old woman reported automatic behaviors and communication whilst she was being treated with pramipexole. These episodes vanished after the medication was tapered and she was started on levodopa/carbidopa. I hypothesize that the episodes were related to disordered awareness due to sleep disruption related to this medication.
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Affiliation(s)
- Ruth H Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, 130 W. Kingsbridge Road, Bronx, NY 10468 USA ; Department of Neurology, Mount Sinai School of Medicine, New York City, NY USA
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40
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Lopez R, Dauvilliers Y. Is Restless Legs Syndrome Involved in Ambulation Related to Sleepwalking? Sleep 2016; 39:955-6. [PMID: 26856908 DOI: 10.5665/sleep.5662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/15/2015] [Indexed: 11/03/2022] Open
Affiliation(s)
- Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France.,Inserm, U1061, Montpellier, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France.,Inserm, U1061, Montpellier, France
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Oldham MA, Desan PH. Alcohol and Sedative-Hypnotic Withdrawal Catatonia: Two Case Reports, Systematic Literature Review, and Suggestion of a Potential Relationship With Alcohol Withdrawal Delirium. PSYCHOSOMATICS 2015; 57:246-55. [PMID: 26949118 DOI: 10.1016/j.psym.2015.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/17/2015] [Accepted: 12/17/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Withdrawal from alcohol and sedative-hypnotics can be complicated by seizures, hallucinations, or delirium. Withdrawal catatonia is another, less commonly discussed complication that clinicians should appreciate. METHODS We present a case of alcohol withdrawal catatonia and a case of benzodiazepine withdrawal catatonia and offer a systematic review of previous cases of alcohol or sedative-hypnotic withdrawal catatonia. We outline clinical features that suggest a potential link between withdrawal catatonia and withdrawal delirium. RESULTS We identified 26 cases of withdrawal catatonia in the literature-all principally with catatonic stupor-with an average age of 56 years (range: 27-92) and balanced prevalence between sexes. Withdrawal catatonia tends to occur only after chronic use of alcohol or sedative-hypnotic agents with a typical onset of 3-7 days after discontinuation and duration of 3-10 days. Withdrawal catatonia is responsive to benzodiazepines or electroconvulsive therapy. Features that suggest a parallel between withdrawal catatonia and withdrawal delirium include time course, neurobiologic convergence, efficacy of benzodiazepines and electroconvulsive therapy, typical absence of abnormal electroencephalographic findings, and phenotypic classification suggested by a recent literature in sleep medicine. CONCLUSION Alcohol and sedative-hypnotic withdrawal may present with catatonia or catatonic features. The clinical and neurobiologic convergence between withdrawal catatonia and withdrawal delirium deserves further attention. In view of these similarities, we propose that withdrawal delirium may represent excited catatonia: these new viewpoints may serve as a substrate for a better understanding of the delirium-catatonia spectrum.
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Affiliation(s)
- Mark A Oldham
- Department of Psychiatry, Yale School of Medicine, New Haven, CT.
| | - Paul H Desan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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