title: Dissociated local arousal states underlying essential clinical features of non-rapid eye movement arousal parasomnia: an intracerebral stereo-electroencephalographic study.
abstract: Sleep has been shown to be a global phenomenon in which the presence of local processes of both activation and deactivation are finely orchestrated. Dysfunctional and independent action of the systems involved in non-rapid eye movement (NREM) sleep and wakefulness is deemed to be at the basis of arousal parasomnias. We show, in a patient with confusional arousals, persistence of sleep in the hippocampal and frontal associative cortices in contrast to the presence of awakening in the motor, cingulate, insular, amygdalar and temporopolar cortices. The clinical features of the confusional arousals in this patient are highly consistent with a dysfunctional coexistence of local cortical arousal and local cortical sleep.
authors.affiliation: Sleep Medicine and Epilepsy Unit, IRCCS National Neurological Institute C. Mondino 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: Valter
authors.initials: V
authors.lastname: Rustioni
authors.forename: Paola
authors.initials: P
authors.lastname: Proserpio
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; D002540:Cerebral Cortex / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D006801:Humans; D008297:Male; D020921:Sleep Arousal Disorders / Q000503:physiopathology*; D012894:Sleep Stages; D014851:Wakefulness