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Sleep spindles in small lesions around basal ganglia — with particular reference to caudate lesions
$205 POLYSOMNOGRAPHY: FUNCTIONAL T O P O GRAPHICAL EXAMINATION OF T H E BASAL GANGLIA. P38.09
M. Segawa, Y. Nomura, E. Nagata and S. Hakamada
etc., were also observed in the cerebral hemispheres, thalamus and reticular system in the pons and medulla. Implications of brain lesions in waking apnoea will be discussed.
(Tokyo, Japan) Body movements (BM) during sleep were evaluated in disorders of various kinds involving the basal ganglia. Besides routine sleep parameters, two types of BM were assessed by surface electrodes: twitch movement (TM) muscle activity lasting less than 0.5 sec., localizing in one muscle and gross movement (GM) - diffuse muscle activity including that of the trunk muscle and lasting more than 2 sec. Data were compared between L-dopa responders and non-responders and between the normal and affected side with unilateral lesions. The nigrostriatal dopaminergic (DA) neurone modulates particular parameters of BM during sleep. It modulates the rates of occurrence of GM against each sleep stage (pattern of GM) and the number of TM, particularly that of the REM stage. The DA neurone, if hypofunctional, increases GMN in stage II and decreases GMN in stages I and REM. It decreases TM and increases REMs thus decreasing T M / R E M s . If hyperfunctional, the reverse is observed in the TM and REMs parameters, while in GM the ratio of REM stage decreases. In unilateral lesions, the pattern of GM and T M / R E M s ratio reflects the side lesioned and TM reflects the condition of the side involved. Thus, polysomnography could be useful in detecting the functional topography of the basal ganglia.
P38.10 N E U R O P A T H O L O G 1 C A L BACKGROUND CENTRAL APNOEA IN BRAIN-STEM LESIONS.
OF
Y. Doi, M. Sugama, J. Sato, Y. Ishihara, Y. Nagashima and H. Sasaki
]>38.11 SLEEP S P I N D L E S IN SMALL L E S I O N S AROUND BASAL GANGLIA - W i T H PARTICULAR REFERENCE TO CAUDATE LESIONS.
H. lwanaga. S. Utsumi, K. Kyoi, S. Miyamoto, K. Kamada and M. Honda (Osaka, Japan) We assume that for the production of normal sleep spindles, three systems: the spindle generator and its projection system, the symmetry maintenance system, and the generator regulation system should operate properly, and that a dysfunction of the regulating system may cause exaggerated activities such as extreme spindles or prolonged spindles. To confirm the possibility that the caudate nucleus, one of the inhibitory systems, may participate in regulating the generator, we selected 54 patients with small infarctions or haemorrhage around the basal ganglia and studied the appearance of spindles. Results were as follows:- 1) In the cases with caudate lesions, the mean duration of spindles was 2.39 +- 0.56 seconds, whilst in the cases without any caudate lesions, 1.21 +_0.40 seconds (p < 0.001); 2) In the cases with caudate infarctions, no significant difference was found in the duration of spindles between the hemisphere with caudate lesions and the other without them; 3) In the cases with thalamic haemorrhage extending upward to the caudate nucleus, prolonged spindles were observed on the unaffected side. The results suggest that the caudate nucleus may participate in the regulation system to some extent and regulatory dysfunction on one side may also influence the opposite side.
(Tokyo, Japan) A central type of apnoea and related respiratory disturbances were investigated polygraphically in 5 patients with brain-stem lesions, ranging from 2 to 81 years old. Two of them were diagnosed as olivopontocerebellar atrophy, two as severe cerebral palsy and one was suspected Wernicke's encephalopathy. Two of them were male and three were female. 1. apnoea was classified into 2 types. In type I, respiratory arrest occurred suddenly without any prodromal sign. A disturbance of the pacemaker of the respiratory rhythm may be the attributable cause in this type of disorder. After tachypnoea or a sigh, marked decrease in amplitude of respiration or arrest occurred in type I1, in which the feedback system to blood gas etc. may be disorganized. 2. Very noticeable was the apnoea observed in the waking state. In 3 cases, waking apnoea occurred more frequently than sleep apnoea. 3. Neuropathological examination revealed marked lesions in the nucleus solitarius and the Raphe nuclei in the ports and medulla in all cases. Some pathological findings such as loss of nerve cells, gliosis
P38.12 SLEEP S P I N D L E S IN PATIENTS W I T H SMALL THALAMIC HAEMORRHAGES.
M. Honda, H. lwanaga, S. Utsumi, K. Kamada. S. Miyamoto and K. Kyoi (Nara, Japan) Production of sleep spindles in patients with a small thalamic haemorrhage is usually inhibited on the bleeding side, while the duration of sleep spindles is sometimes prolonged on the contralateral side. We selected 21 patients with a small thalamic haemorrhage which was validated by CT, and analyzed the sleep spindles, in comparison with the findings of the waking EEG, within two weeks of onset. 14 of 21 cases had normal findings in the waking EEG without lateralisation of background activity. In contrast, in the sleep EEG in 15 out of 21 cases production of sleep spindles
M. Segawa, Y. Nomura, E. Nagata and S. Hakamada
etc., were also observed in the cerebral hemispheres, thalamus and reticular system in the pons and medulla. Implications of brain lesions in waking apnoea will be discussed.
(Tokyo, Japan) Body movements (BM) during sleep were evaluated in disorders of various kinds involving the basal ganglia. Besides routine sleep parameters, two types of BM were assessed by surface electrodes: twitch movement (TM) muscle activity lasting less than 0.5 sec., localizing in one muscle and gross movement (GM) - diffuse muscle activity including that of the trunk muscle and lasting more than 2 sec. Data were compared between L-dopa responders and non-responders and between the normal and affected side with unilateral lesions. The nigrostriatal dopaminergic (DA) neurone modulates particular parameters of BM during sleep. It modulates the rates of occurrence of GM against each sleep stage (pattern of GM) and the number of TM, particularly that of the REM stage. The DA neurone, if hypofunctional, increases GMN in stage II and decreases GMN in stages I and REM. It decreases TM and increases REMs thus decreasing T M / R E M s . If hyperfunctional, the reverse is observed in the TM and REMs parameters, while in GM the ratio of REM stage decreases. In unilateral lesions, the pattern of GM and T M / R E M s ratio reflects the side lesioned and TM reflects the condition of the side involved. Thus, polysomnography could be useful in detecting the functional topography of the basal ganglia.
P38.10 N E U R O P A T H O L O G 1 C A L BACKGROUND CENTRAL APNOEA IN BRAIN-STEM LESIONS.
OF
Y. Doi, M. Sugama, J. Sato, Y. Ishihara, Y. Nagashima and H. Sasaki
]>38.11 SLEEP S P I N D L E S IN SMALL L E S I O N S AROUND BASAL GANGLIA - W i T H PARTICULAR REFERENCE TO CAUDATE LESIONS.
H. lwanaga. S. Utsumi, K. Kyoi, S. Miyamoto, K. Kamada and M. Honda (Osaka, Japan) We assume that for the production of normal sleep spindles, three systems: the spindle generator and its projection system, the symmetry maintenance system, and the generator regulation system should operate properly, and that a dysfunction of the regulating system may cause exaggerated activities such as extreme spindles or prolonged spindles. To confirm the possibility that the caudate nucleus, one of the inhibitory systems, may participate in regulating the generator, we selected 54 patients with small infarctions or haemorrhage around the basal ganglia and studied the appearance of spindles. Results were as follows:- 1) In the cases with caudate lesions, the mean duration of spindles was 2.39 +- 0.56 seconds, whilst in the cases without any caudate lesions, 1.21 +_0.40 seconds (p < 0.001); 2) In the cases with caudate infarctions, no significant difference was found in the duration of spindles between the hemisphere with caudate lesions and the other without them; 3) In the cases with thalamic haemorrhage extending upward to the caudate nucleus, prolonged spindles were observed on the unaffected side. The results suggest that the caudate nucleus may participate in the regulation system to some extent and regulatory dysfunction on one side may also influence the opposite side.
(Tokyo, Japan) A central type of apnoea and related respiratory disturbances were investigated polygraphically in 5 patients with brain-stem lesions, ranging from 2 to 81 years old. Two of them were diagnosed as olivopontocerebellar atrophy, two as severe cerebral palsy and one was suspected Wernicke's encephalopathy. Two of them were male and three were female. 1. apnoea was classified into 2 types. In type I, respiratory arrest occurred suddenly without any prodromal sign. A disturbance of the pacemaker of the respiratory rhythm may be the attributable cause in this type of disorder. After tachypnoea or a sigh, marked decrease in amplitude of respiration or arrest occurred in type I1, in which the feedback system to blood gas etc. may be disorganized. 2. Very noticeable was the apnoea observed in the waking state. In 3 cases, waking apnoea occurred more frequently than sleep apnoea. 3. Neuropathological examination revealed marked lesions in the nucleus solitarius and the Raphe nuclei in the ports and medulla in all cases. Some pathological findings such as loss of nerve cells, gliosis
P38.12 SLEEP S P I N D L E S IN PATIENTS W I T H SMALL THALAMIC HAEMORRHAGES.
M. Honda, H. lwanaga, S. Utsumi, K. Kamada. S. Miyamoto and K. Kyoi (Nara, Japan) Production of sleep spindles in patients with a small thalamic haemorrhage is usually inhibited on the bleeding side, while the duration of sleep spindles is sometimes prolonged on the contralateral side. We selected 21 patients with a small thalamic haemorrhage which was validated by CT, and analyzed the sleep spindles, in comparison with the findings of the waking EEG, within two weeks of onset. 14 of 21 cases had normal findings in the waking EEG without lateralisation of background activity. In contrast, in the sleep EEG in 15 out of 21 cases production of sleep spindles