title: Evidence of dissociated arousal states during NREM parasomnia from an intracerebral neurophysiological study.
abstract: OBJECTIVE
  Arousal parasomnias are expressions of sleep/ wake state dissociations in which wakefulness and NREM sleep seem to coexist. We describe the results of a neurophysiological (intracerebral EEG) investigation that captured an episode of confusional arousal.
  
  
  METHODS
  Observational analysis.
  
  
  METHODS
  Tertiary sleep center.
  
  
  METHODS
  A 20-year-old male with refractory focal epilepsy.
  
  
  RESULTS
  The intracerebral EEG findings documented the presence of a local arousal of the motor and cingulate cortices associated with increased delta activity in the frontoparietal associative cortices; these findings were noted preceding the onset and persisting throughout the episode.
  
  
  CONCLUSIONS
  The presence of dissociated sleep/wake states in confusional arousals is the expression not of a global phenomenon, but rather of the coexistence of different local states of being: arousal of the motor and cingulate cortices and inhibition of the associative ones. Whether this is an exclusive feature of NREM parasomnias, or a common substrate on which other triggering elements act, needs to be clarified.
authors.affiliation: Sleep Medicine and Epilepsy Unit, IRCCS "C. Mondino Institute of Neurology" Foundation, Pavia, Italy. michele.terzaghi@mondino.it
authors.forename: Michele
authors.initials: M
authors.lastname: Terzaghi
authors.forename: Ivana
authors.initials: I
authors.lastname: Sartori
authors.forename: Laura
authors.initials: L
authors.lastname: Tassi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Didato
authors.forename: Valter
authors.initials: V
authors.lastname: Rustioni
authors.forename: Giorgio
authors.initials: G
authors.lastname: LoRusso
authors.forename: Raffaele
authors.initials: R
authors.lastname: Manni
authors.forename: Lino
authors.initials: L
authors.lastname: Nobili
mesh_terms: D001143:Arousal / Q000502:physiology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D004213:Dissociative Disorders / Q000503:physiopathology*; D004292:Dominance, Cerebral / Q000502:physiology; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000503:physiopathology* / Q000601:surgery; D005625:Frontal Lobe / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008297:Male; D009044:Motor Cortex / Q000503:physiopathology; D009415:Nerve Net / Q000503:physiopathology; D020447:Parasomnias / Q000503:physiopathology*; D010296:Parietal Lobe / Q000503:physiopathology; D012815:Signal Processing, Computer-Assisted; D012894:Sleep Stages / Q000502:physiology*; D013009:Somnambulism / Q000503:physiopathology; D014741:Video Recording; D055815:Young Adult