{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:55:17Z","timestamp":1785412517607,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Important brainstem regions are involved in the regulation of rapid eye movement sleep. We hypothesized that brainstem stroke is associated with dysregulated rapid eye movement sleep and related muscle activity. We compared quantitative\/qualitative polysomnography features of rapid eye movement sleep and muscle activity (any, phasic, tonic) between 15 patients with brainstem stroke (<jats:italic>N<\/jats:italic>\u00a0=\u00a046 rapid eye movement periods), 16 patients with lacunar\/non\u2010brainstem stroke (<jats:italic>N<\/jats:italic>\u00a0=\u00a040 rapid eye movement periods), 15 healthy controls (<jats:italic>N<\/jats:italic>\u00a0=\u00a062 rapid eye movement periods), and patients with Parkinson's disease and polysomnography\u2010confirmed rapid eye movement sleep behaviour disorder. Further, in the brainstem group, we performed a magnetic resonance imaging\u2010based lesion overlap analysis. The mean ratio of muscle activity to rapid eye movement sleep epoch in the brainstem group (\u201cany\u201d muscle activity 0.09\u2009\u00b1\u20090.15; phasic muscle activity 0.08\u2009\u00b1\u20090.14) was significantly lower than in the lacunar group (\u201cany\u201d muscle activity 0.17\u2009\u00b1\u20090.2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05; phasic muscle activity 0.16\u2009\u00b1\u20090.19, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), and also lower than in the control group (\u201cany\u201d muscle activity 0.15\u2009\u00b1\u20090.17, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Magnetic resonance imaging\u2010based lesion analysis indicated an area of maximum overlap in the medioventral pontine region for patients with reduced phasic muscle activity index. For all groups, mean values of muscle activity were significantly lower than in the patients with Parkinson's disease and polysomnography\u2010confirmed REM sleep behaviour disorder group (\u201cany\u201d activity 0.51\u2009\u00b1\u20090.26, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001 for all groups; phasic muscle activity 0.42\u2009\u00b1\u20090.21, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001 for all groups). For the tonic muscle activity in the mentalis muscle, no significant differences were found between the groups.<\/jats:p><jats:p>In the brainstem group, contrary to the lacunar and the control groups, \u201cany\u201d muscle activity index during rapid eye movement sleep was significantly reduced after the third rapid eye movement sleep phase.<\/jats:p><jats:p>This study reports on the impact of brainstem stroke on rapid eye movement atonia features in a human cohort. Our findings highlight the important role of the human brainstem, in particular the medioventral pontine regions, in the regulation of phasic muscle activity during rapid eye movement sleep and the ultradian distribution of rapid eye movement\u2010related muscle activity.<\/jats:p>","DOI":"10.1111\/jsr.13640","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T01:08:58Z","timestamp":1653440938000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<scp>REM<\/scp> sleep and muscle atonia in brainstem stroke: A quantitative polysomnographic and lesion analysis study"],"prefix":"10.1111","volume":"32","author":[{"given":"Nathalie","family":"Tellenbach","sequence":"first","affiliation":[{"name":"Department of Neurology University Hospital (Inselspital) and University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus H.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital (Inselspital) and University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Alexiev","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital (Inselspital) and University of Bern  Bern Switzerland"},{"name":"Neurology Clinic St Anna University Hospital  Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Blondiaux","sequence":"additional","affiliation":[{"name":"Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics and Brain Mind Institute, Faculty of Life Sciences Swiss Federal institute of Technology (EPFL)  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Cavalloni","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital (Inselspital) and University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio L.","family":"Bassetti","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital (Inselspital) and University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Heydrich","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital (Inselspital) and University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6502-8942","authenticated-orcid":false,"given":"Panagiotis","family":"Bargiotas","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital (Inselspital) and University of Bern  Bern Switzerland"},{"name":"Department of Neurology, Medical School University of Cyprus  Nicosia 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