REM sleep abnormalities in severe athetoid cerebral palsy
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M Hayashi1, Y Inoue, Y Iwakawa
1Department of Pediatrics, Tokyo Medical and Dental University, Japan.
Insights
This study found that individuals with severe athetoid cerebral palsy (ACP) often exhibit REM sleep disturbances, including reduced eye movements and abnormal muscle tone. These findings suggest potential brainstem dysfunction in perinatal ACP patients.
Area of Science:
- Neurology
- Sleep Medicine
- Neuroscience
Background:
- Extrapyramidal diseases, such as cerebral palsy, are known to cause various sleep abnormalities.
- Athetoid cerebral palsy (ACP) originating perinatally is a severe form of extrapyramidal disease.
- Understanding sleep disturbances in ACP is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate disturbances in REM sleep (SREM) in patients with severe perinatal athetoid cerebral palsy (ACP).
- To analyze body movements during sleep and their correlation with sleep stages in ACP patients.
- To explore the potential link between SREM abnormalities in ACP and brainstem function.
Main Methods:
- Conducted all-night polygraphic examinations on ten ACP patients (5 males, 5 females, aged 15-30).
- Analyzed rapid eye movements (REMs) and submental muscle tone during SREM.
- Quantified and analyzed gross and twitch body movements across different sleep stages.
Main Results:
- Three out of ten ACP patients showed a marked decrease in REMs during SREM.
- Submental muscle tone during SREM was disturbed in three patients.
- Most patients exhibited abnormal distribution of body movements, with significantly reduced movements during SREM.
Conclusions:
- Perinatal athetoid cerebral palsy is associated with significant disturbances in REM sleep.
- Observed REM sleep abnormalities and altered body movements suggest potential brainstem dysfunction in ACP.
- Findings highlight the need to consider brainstem involvement in the pathophysiology of sleep disorders in severe perinatal ACP.
Abstract:
Various abnormalities of sleep have been reported in extrapyramidal diseases in adults. We have investigated the disturbances of REM sleep (SREM) in severe athetoid cerebral palsy (ACP) originating perinatally. Ten ACP patients, 5 males and 5 females ranging from 15 to 30 years old, were studied by means of all-night polygraphic examination. Three cases showed a marked decrease in rapid eye movements in SREM. Moreover, the tone of submental muscle in SREM was also disturbed in three. Regarding body movements during sleep, gross movements and twitch movements of the submental muscle were analyzed. In most of the patients, an abnormal distribution of body movements according to sleep stages was observed, the rate being significantly reduced in SREM. REMs, atonia and body movements are considered to be related to the brainstem function in animals. The results of the present study suggest that perinatal extrapyramidal diseases could also coincide with brainstem dysfunctions.