DAY 4: PARASOMNIA I MOVEMENT DISORDERS Flashcards
How does age affect position changes during sleep?
As we age, our ability to maintain a static position during sleep decreases, and older individuals tend to experience more frequent position changes during sleep compared to younger individuals. This age-related increase in movement during sleep is known as nocturnal motor activity.
What is atonia, and why is it necessary during sleep?
Atonia refers to the reduction in muscle tone during sleep, both in non-rapid eye movement (NREM) and rapid eye movement (REM) phases. It is necessary to prevent us from physically acting out our dreams during REM sleep.
What are REM phasic motor events?
REM phasic motor events are twitches or jerks that happen during rapid eye movement (REM) sleep. They occur due to the activation of motor circuits during REM sleep and are associated with bursts of eye movement and vivid dreams.
What happens to the membrane potential of neurons during wakefulness?
During wakefulness, the membrane potential of neurons tends to be hyperpolarized. Hyperpolarization helps regulate neuronal excitability and maintains the appropriate balance of neural activity during wakefulness.
What is the role of the cholinergic system in motor regulation during sleep?
The cholinergic system, specifically the Lateral Dorsal Tegmental Nucleus (LDT) and Pedunculopontine Tegmental Nucleus (PPT), is involved in the regulation of sleep and wakefulness. These brain regions utilize the neurotransmitter acetylcholine to modulate arousal, attention, and motor functions.
How are motor excitability changes during REM sleep assessed?
Motor excitability during sleep can be assessed using techniques such as single-pulse transcranial magnetic stimulation (spTMS). Studies have shown that there are specific changes in cortical-motor excitability during REM sleep compared to other sleep stages.
What changes occur in the brain during Slow-Wave Sleep (SWS)?
During Slow-Wave Sleep (SWS), there is an increase in intracortical inhibition, which refers to the suppression of neural activity within the cerebral cortex. This helps maintain sleep depth and prevent unwanted motor activity.
How does REM sleep differ from SWS regarding cortical activity?
In contrast to SWS, REM sleep is associated with a decrease in intracortical facilitation, which refers to the enhancement of neural activity within the cerebral cortex. This reduction in facilitation during REM sleep contributes to the inhibition of voluntary muscle movements, promoting atonia.
What is the role of glutamate in sleep-wake regulation?
Glutamate is the primary excitatory neurotransmitter in the central nervous system and plays a crucial role in various physiological processes, including sleep-wake regulation.
How does glycine help us sleep better?
Glycine helps us sleep better through various mechanisms, including promoting muscle atonia during REM sleep, facilitating sleep initiation, improving sleep quality, and maintaining a balance between excitatory and inhibitory processes in the brain.
What is Sleep-Related Hypermotor Epilepsy (SHE), and who is more likely to experience it?
Sleep-Related Hypermotor Epilepsy (SHE) is a type of epilepsy characterized by recurrent seizures that predominantly occur during the night and are more frequent in individuals under 20 years old.
What are some related parasomnia symptoms that may occur during the first part of sleep in individuals with SHE?
Some related parasomnia symptoms that may occur during the first part of sleep in individuals with SHE include sleepwalking, sleep terror, eating disorders, and confusional arousal.
What are the predisposing factors for the development of SHE?
The development of SHE is influenced by various predisposing factors, including genetics. A family history of Dystonic Disorders with Daytime-onset Affect (DOA) is a significant predisposing factor. Additionally, specific genetic factors such as chromosome 20q12-q13 and HLA DQB1:05:01 may play a role in susceptibility to SHE.
What triggers can exacerbate seizures in individuals with SHE?
Several priming factors can trigger or exacerbate seizures in individuals with SHE. These triggers include environmental factors like noise and pollution, various sleep disorders such as narcolepsy and sleep-disordered breathing, as well as emotional stress and the use of medications affecting the central nervous system
Which parts of the brain are affected during seizures associated with SHE, and what manifestations of symptoms can occur?
During seizures associated with SHE, the motor cortex is affected, leading to hypermotor activity. The frontoparietal association cortex can be impacted, potentially resulting in altered states of consciousness. The limbic cortices and amygdala may contribute to emotional aspects of seizures. Lastly, the hippocampus may be affected, leading to memory disturbances during and after seizures.
What is REM Behavior Disorder (RBD)?
REM Behavior Disorder (RBD) is a sleep disorder characterized by complex and violent motor behaviors that occur during REM (rapid eye movement) sleep. Unlike in normal REM sleep, individuals with RBD lack the usual muscle atonia, leading to the manifestation of their dreams through physical movements and vocalizations.
What are some characteristics of RBD?
Characteristics of RBD include complex motor behavior, violent motor behavior in some cases, and emotional expression like laughing or crying that corresponds to the dream content during REM sleep.
What are the symptoms of RBD?
Symptoms of RBD include vivid visual and verbal activities during dream episodes, cognitive impairments like memory problems, and emotional disturbances such as anger expression, depression, and increased stress levels.
What are some potential triggers for RBD?
Certain medications, specifically antidepressants and MAO inhibitors, have been identified as potential triggers for RBD. These medications can interfere with the neurotransmitter systems that regulate REM sleep and muscle atonia during this sleep stage, leading to RBD symptoms.
What is the association between RBD and Parkinson’s disease?
Research has shown a significant association between RBD and the development of Parkinson’s disease (PD). Approximately 20% of individuals with RBD may present RBD symptoms during the premotor phase of Parkinson’s, even before motor symptoms of PD become evident. Additionally, around 43% of individuals newly diagnosed with PD may have a history of RBD symptoms before the motor symptoms of PD manifest.
What is Restless Legs Syndrome (RLS) characterized by?
Restless Legs Syndrome (RLS) is a neurological disorder characterized by an irresistible urge to move the legs, often accompanied by continuous, unpleasant sensations during the night. Patients may describe these sensations as aching, throbbing, itching, or crawling.
What are some of the characteristics of RLS?
Some characteristics of RLS include continuous nighttime sensations in the legs, involuntary leg movements, and restlessness due to the urge to move the legs to relieve discomfort.
What type of treatment is commonly used to manage RLS?
Dopaminergic agents, such as dopamine agonists, are commonly used to treat RLS. These medications work by enhancing dopamine activity in the brain, which helps alleviate RLS symptoms and improve sleep quality.
How can RLS manifest in patients?
RLS can manifest as either chronic persistent RLS/WED, where symptoms occur frequently and persistently, or intermittent RLS/WED, where symptoms occur episodically.
What has CSF analysis revealed in individuals with RLS?
CSF analysis in individuals with RLS has shown high levels of Transferrin, a protein that transports iron, and low levels of Ferritin, a protein that stores iron. This suggests reduced iron stores in the brain.
