Neural circuitry underlying REM sleep: A review of the literature and current concepts. (September 2021)

• Record Type: Journal Article
• Authors: Wang, Yi-Qun; Liu, Wen-Ying; Li, Lei; Qu, Wei-Min; Huang, Zhi-Li
• Is Part Of: Progress in neurobiology. Volume 204(2021)
• Publication Date: 2021-09
• Subjects: Rapid eye movement sleep -- REM sleep-regulatory model -- REM sleep behavior disorder -- Narcolepsy; CNZ clonazepam -- DLB dementia with Lewy bodies -- DMH dorsomedial hypothalamic nucleus -- DPGi dorsal paragigantocellular nucleus -- DRN dorsal raphe nucleus -- EDS excessive daytime sleepiness -- EEG electroencephalogram -- GABA γ-aminobutyric acid -- HCRT hypocretin -- LC locus coeruleus -- LDT laterodorsal tegmental nucleus -- LH lateral hypothalamic area -- LPGi lateral paragigantocellular nucleus -- LPT lateral pontine tegmentum -- MCH melanin-concentrating hormone -- NREM non-REM -- PD Parkinson's disease -- PGO ponto-geniculo-occipital -- PnO oral pontine reticular nucleus -- PPT pedunculopontine tegmental nucleus -- PRF pontine/mesencephalic reticular formation -- RBD REM sleep behavior disorder -- REM rapid eye movement -- SLD sublaterodorsal tegmental nucleus -- SubC subcoeruleus nucleus -- vlPAG ventrolateral periaqueductal gray matter -- vMM ventromedial medulla; Neurobiology -- Periodicals; Neurology -- Periodicals; Neurology -- Periodicals; Neurobiologie -- Périodiques; 612.8
• DOI: 10.1016/j.pneurobio.2021.102106
• Languages: English
• ISSNs: 0301-0082

Abstract

Highlights: The characteristics of REM sleep include hippocampal theta oscillations, cortical activation and muscle atonia. Neurons in the medulla, brain stem and pons are important to REM sleep regulation, especially the LDT/PPT, the PRF, the SLD and the LPGi. A model involving different types of neurons emphasizes the importance of LH MCH neurons in REM sleep onset and maintenance. CNZ and melatonin are the most effective drugs for RBD, while sodium oxybate is the first-line medication for narcolepsy. Abstract: As one of the fundamental sleep states, rapid eye movement (REM) sleep is believed to be associated with dreaming and is characterized by low-voltage, fast electroencephalographic activity and loss of muscle tone. However, the mechanisms of REM sleep generation have remained unclear despite decades of research. Several models of REM sleep have been established, including a reciprocal interaction model, limit-cycle model, flip-flop model, and a model involving γ-aminobutyric acid, glutamate, and aminergic/orexin/melanin-concentrating hormone neurons. In the present review, we discuss these models and summarize two typical disorders related to REM sleep, namely REM sleep behavior disorder and narcolepsy. REM sleep behavior disorder is a sleep muscle-tone-related disorder and can be treated with clonazepam and melatonin. Narcolepsy, with core symptoms of excessive daytime sleepiness and cataplexy, is strongly connected with orexin in early adulthood.