{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:13:58Z","timestamp":1784146438886,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T00:00:00Z","timestamp":1097193600000},"content-version":"vor","delay-in-days":3112,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[1996,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Paramedian thalamic stroke (PTS) is a cause of organic hypersomnia, which in the absence of systematic sleep\u2010wake studies has been attributed to disruption of ascending activating impulses and considered a \u201cearoused\u201d state. However, an increasing amount of data suggests a role of the thalamus in sleep regulation and raises the possibility that a sleep disturbance contributes to hypersomnia in PTS. We evaluated 12 patients with magnetic resonance imaging\u2010proven isolated PTS and hypersomnia with 10 to &gt;20 hours of sleep behavior per day. Nocturnal polysomnographic findings paralleled the severity of hypersomnia. All subjects had increased stage 1 NREM sleep, reduced stage 2 NREM sleep, and reduced numbers of sleep spindles. In patients with severe hypersomnia, slow\u2010wave (stages 3\u20104) NREM sleep was often reduced, but there were no major REM sleep alterations. Daytime sleep behavior was associated mostly with stage 1 sleep by electroencephalogram; there was no correlation between hypersomnia and results of nap tests. We conclude that hypersomnia following PTS is accompanied by deficient arousal during the day and insufficient spindling and slow\u2010wave sleep production at night. These observations support the hypothesis of a dual role of the paramedian thalamus as \u201cfinal common pathway\u201d for both maintenance of wakefulness and promotion of NREM sleep.<\/jats:p>","DOI":"10.1002\/ana.410390409","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T16:33:31Z","timestamp":1104597211000},"page":"471-480","source":"Crossref","is-referenced-by-count":175,"title":["Hypersomnia following paramedian thalamic stroke: A report of 12 patients"],"prefix":"10.1002","volume":"39","author":[{"given":"Claudio","family":"Bassetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Marhis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Gugger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl O.","family":"Lovblad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian W.","family":"Hess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,8]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"1215","article-title":"Zur Klinik und Anatomie der vertikalen Blickl\u00fch\u2010mung","volume":"32","author":"Freund SC","year":"1913","journal-title":"Neurol Zentralbl"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410100204"},{"key":"e_1_2_1_4_2","first-page":"547","article-title":"Etude topographique des l\u00e9sions anaromiques dans les hypersomnies","volume":"116","author":"Castaigne P","year":"1967","journal-title":"Rev Neurol"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.4.647"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/116.6.1549"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3940(88)90355-2"},{"key":"e_1_2_1_8_2","first-page":"135","volume-title":"Fatal familial insomnia: inherited prion diseases, sle and the thalamus","author":"Mancia M","year":"1994"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0013-4694(89)90190-9"},{"key":"e_1_2_1_10_2","first-page":"284","article-title":"Funktion und Lokalisation des Schlafes","volume":"86","author":"Tr\u00f6mner E","year":"1929","journal-title":"Arch Psychiatrie"},{"key":"e_1_2_1_11_2","first-page":"287","article-title":"Hirnreizversuche \u00fcber den Mechanismus des Schlafes","volume":"86","author":"Hess WR","year":"1929","journal-title":"Arch Psychiatrie"},{"key":"e_1_2_1_12_2","first-page":"9","article-title":"Basic mechanisms of sleep generation","volume":"42","author":"Steriade M","year":"1992","journal-title":"Neurology"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.8235588"},{"key":"e_1_2_1_14_2","first-page":"348","article-title":"Sleep\u2010wakefuless, EEG, and behavioural studies of chronic cats without the thalamus: the \u201cathalamic\u201d cat","volume":"110","author":"Villablanca J","year":"1972","journal-title":"Arch Ital Biol"},{"key":"e_1_2_1_15_2","first-page":"145","volume-title":"Principles and practice of sleep medicine","author":"Jones RE","year":"1994"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198610163151605"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/17.8.703"},{"key":"e_1_2_1_18_2","volume-title":"Core text of neuroanatomy","author":"Carpenter MB","year":"1985"},{"key":"e_1_2_1_19_2","volume-title":"Neuroanatomy. 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