Parrino Liborio, Halasz Peter, Tassinari Carlo Alberto, Terzano Mario Giovanni
Sleep Disorders Center, Department of Neuroscience, University of Parma, Via Gramsci, 14, 43100 Parma, Italy.
Sleep Med Rev. 2006 Aug;10(4):267-85. doi: 10.1016/j.smrv.2005.12.004. Epub 2006 Jun 30.
Arousal systems play a topical neurophysiologic role in protecting and tailoring sleep duration and depth. When they appear in NREM sleep, arousal responses are not limited to a single EEG pattern but are part of a continuous spectrum of EEG modifications ranging from high-voltage slow rhythms to low amplitude fast activities. The hierarchic features of arousal responses are reflected in the phase A subtypes of CAP (cyclic alternating pattern) including both slow arousals (dominated by the <1Hz oscillation) and fast arousals (ASDA arousals). CAP is an infraslow oscillation with a periodicity of 20-40s that participates in the dynamic organization of sleep and in the activation of motor events. Physiologic, paraphysiologic and pathologic motor activities during NREM sleep are always associated with a stereotyped arousal pattern characterized by an initial increase in EEG delta power and heart rate, followed by a progressive activation of faster EEG frequencies. These findings suggest that motor patterns are already written in the brain codes (central pattern generators) embraced with an automatic sequence of EEG-vegetative events, but require a certain degree of activation (arousal) to become visibly apparent. Arousal can appear either spontaneously or be elicited by internal (epileptic burst) or external (noise, respiratory disturbance) stimuli. Whether the outcome is a physiologic movement, a muscle jerk or a major epileptic attack will depend on a number of ongoing factors (sleep stage, delta power, neuro-motor network) but all events share the common trait of arousal-activated phenomena.
觉醒系统在保护和调整睡眠时间及深度方面发挥着重要的神经生理作用。当它们出现在非快速眼动睡眠中时，觉醒反应并不局限于单一的脑电图模式，而是脑电图变化连续谱的一部分，范围从高电压慢节律到低振幅快活动。觉醒反应的层级特征反映在CAP（周期性交替模式）的A期亚型中，包括慢觉醒（以<1Hz振荡为主）和快觉醒（ASDA觉醒）。CAP是一种周期为20 - 40秒的超慢振荡，参与睡眠的动态组织和运动事件的激活。非快速眼动睡眠期间的生理、准生理和病理运动活动总是与一种刻板的觉醒模式相关，其特征是脑电图δ波功率和心率最初增加，随后更快的脑电图频率逐渐激活。这些发现表明，运动模式已经编码在大脑中（中枢模式发生器），伴随着脑电图 - 自主神经事件的自动序列，但需要一定程度的激活（觉醒）才能明显显现。觉醒可以自发出现，也可以由内部（癫痫发作）或外部（噪音、呼吸干扰）刺激引发。结果是生理运动、肌肉抽搐还是重大癫痫发作将取决于许多持续因素（睡眠阶段、δ波功率、神经 - 运动网络），但所有事件都具有觉醒激活现象的共同特征。
