REM sleep and muscle atonia in brainstem stroke: A quantitative polysomnographic and lesion analysis study.

Tellenbach, Nathalie; Schmidt, Markus H; Alexiev, Filip; Blondiaux, Eva; Cavalloni, Fabian; Bassetti, Claudio L; Heydrich, Lukas; Bargiotas, Panagiotis (2023). REM sleep and muscle atonia in brainstem stroke: A quantitative polysomnographic and lesion analysis study. Journal of sleep research, 32(2), e13640. Wiley 10.1111/jsr.13640

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Important brainstem regions are involved in the regulation of rapid eye movement sleep. We hypothesized that brainstem stroke is associated with dysregulated rapid eye movement sleep and related muscle activity. We compared quantitative/qualitative polysomnography features of rapid eye movement sleep and muscle activity (any, phasic, tonic) between 15 patients with brainstem stroke (N = 46 rapid eye movement periods), 16 patients with lacunar/non-brainstem stroke (N = 40 rapid eye movement periods), 15 healthy controls (N = 62 rapid eye movement periods), and patients with Parkinson's disease and polysomnography-confirmed rapid eye movement sleep behaviour disorder. Further, in the brainstem group, we performed a magnetic resonance imaging-based lesion overlap analysis. The mean ratio of muscle activity to rapid eye movement sleep epoch in the brainstem group ("any" muscle activity 0.09 ± 0.15; phasic muscle activity 0.08 ± 0.14) was significantly lower than in the lacunar group ("any" muscle activity 0.17 ± 0.2, p < 0.05; phasic muscle activity 0.16 ± 0.19, p < 0.05), and also lower than in the control group ("any" muscle activity 0.15 ± 0.17, p < 0.05). Magnetic resonance imaging-based lesion analysis indicated an area of maximum overlap in the medioventral pontine region for patients with reduced phasic muscle activity index. For all groups, mean values of muscle activity were significantly lower than in the patients with Parkinson's disease and polysomnography-confirmed REM sleep behaviour disorder group ("any" activity 0.51 ± 0.26, p < 0.0001 for all groups; phasic muscle activity 0.42 ± 0.21, p < 0.0001 for all groups). For the tonic muscle activity in the mentalis muscle, no significant differences were found between the groups. In the brainstem group, contrary to the lacunar and the control groups, "any" muscle activity index during rapid eye movement sleep was significantly reduced after the third rapid eye movement sleep phase. This study reports on the impact of brainstem stroke on rapid eye movement atonia features in a human cohort. Our findings highlight the important role of the human brainstem, in particular the medioventral pontine regions, in the regulation of phasic muscle activity during rapid eye movement sleep and the ultradian distribution of rapid eye movement-related muscle activity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Schmidt, Markus Helmut, Alexiev, Filip, Cavalloni, Fabian, Bassetti, Claudio L.A., Heydrich, Lukas Emmanuel Josef Marc, Bargiotas, Panagiotis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1365-2869

Publisher:

Wiley

Language:

English

Submitter:

Pubmed Import

Date Deposited:

25 May 2022 12:19

Last Modified:

16 Mar 2023 00:11

Publisher DOI:

10.1111/jsr.13640

PubMed ID:

35609965

Uncontrolled Keywords:

phasic muscle activity pons pontine stroke rapid eye movement sleep behaviour disorder rapid eye movement sleep without atonia (RSWA) tonic muscle activity

BORIS DOI:

10.48350/170245

URI:

https://boris.unibe.ch/id/eprint/170245

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