A new view of "dream enactment" in REM sleep behavior disorder.
A new view of "dream enactment" in REM sleep behavior disorder.
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DOI：
10.1016/j.smrv.2015.12.002
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发表时间：
2016-12
影响因子：
10.5
通讯作者：
Plumeau AM
中科院分区：
文献类型：
--
作者：
Blumberg MS;Plumeau AM
REM睡眠行为障碍（RBD）是一种患者在REM睡眠期间表现出肌张力增加和夸张的肌阵挛性抽搐的疾病。此外，肢体的剧烈运动，以及有时似乎涉及梦境的复杂行为，都与RBD有关。这些行为被广泛认为是脑干中产生弛缓的神经回路功能障碍的结果，从而揭示了皮层产生的梦。在这里，我们仔细研究了导致这种解释RBD的假设。特别是，我们挑战的假设，即运动皮层产生抽搐在REM睡眠，从而质疑相关的假设，即运动皮层是主要负责所有的病理运动的RBD。此外，运动皮层甚至不是产生复杂行为所必需的;例如，刺激某些脑干结构可以在大鼠和猴子中产生防御和攻击行为，这些行为与RBD患者的报告惊人相似。因此，我们建议的解释RBD集中注意力增加脑干作为一个来源的病理运动，并认为感觉反馈从运动的肢体作为一个重要的影响，对内容的梦心理。
REM sleep behavior disorder (RBD) is a disorder in which patients exhibit increased muscle tone and exaggerated myoclonic twitching during REM sleep. In addition, violent movements of the limbs, and complex behaviors that can sometimes appear to involve the enactment of dreams, are associated with RBD. These behaviors are widely thought to result from a dysfunction involving atonia-producing neural circuitry in the brainstem, thereby unmasking cortically generated dreams. Here we scrutinize the assumptions that led to this interpretation of RBD. In particular, we challenge the assumption that motor cortex produces twitches during REM sleep, thus calling into question the related assumption that motor cortex is primarily responsible for all of the pathological movements of RBD. Moreover, motor cortex is not even necessary to produce complex behavior; for example, stimulation of some brainstem structures can produce defensive and aggressive behaviors in rats and monkeys that are striking similar to those reported in human patients with RBD. Accordingly, we suggest an interpretation of RBD that focuses increased attention on the brainstem as a source of the pathological movements and that considers sensory feedback from moving limbs as an important influence on the content of dream mentation.