Mahowald M W, Schenck C H
Department of Neurology, Hennepin County Medical Center, Minneapolis, Minnesota 55415.
Sleep. 1991 Feb;14(1):69-79. doi: 10.1093/sleep/14.1.69.
During the course of routine clinical study, it has become apparent that the all-or-none concept of state determination (wakefulness, nonrapid eye movement sleep, rapid eye movement sleep) does not always exist, and that ambiguous, multiple, or rapid oscillation of state-determining variables appear in a wide variety of experimental and clinical situations. Six cases of extreme state dissociation are presented, with a review of the human and animal clinical and experimental literature. This multiple component concept of state determination must be kept in mind when pharmacologic or lesion studies are employed to suppress one or another state. Such manipulation may suppress some of the commonly used markers for that state (i.e., polygraphic) without affecting other variables of that state. The existence of mixed states will be a challenge to the development of automated computerized polysomnogram scoring.
在常规临床研究过程中，已明显发现状态判定（清醒、非快速眼动睡眠、快速眼动睡眠）的全或无概念并非始终存在，而且在各种实验和临床情况下，状态判定变量会出现模糊、多样或快速振荡的情况。本文介绍了6例极端状态解离病例，并对人类和动物的临床及实验文献进行了综述。在采用药理学或损伤研究来抑制一种或另一种状态时，必须牢记这种状态判定的多成分概念。这种操作可能会抑制该状态的一些常用标记物（即多导睡眠图），而不影响该状态的其他变量。混合状态的存在将对自动化计算机多导睡眠图评分的发展构成挑战。
