Motor-behavioral episodes in REM sleep behavior disorder and phasic events during REM sleep

Raffaele Manni, Michele Terzaghi, Margaret Glorioso

Research output: Contribution to journalArticlepeer-review


Study Objectives: To investigate if sudden-onset motor-behavioral episodes in REM sleep behavior disorder (RBD) are associated with phasic events of REM sleep, and to explore the potential meaning of such an association. Design: Observational review analysis. Setting: Tertiary sleep center. Patients: Twelve individuals (11 males; mean age 67.6 ± 7.4 years) affected by Idiopathic RBD, displaying a total of 978 motor-behavioral episodes during nocturnal in-laboratory video-PSG. Interventions: N/A Measurements and Results: The motor activity displayed was primitive in 69.1% and purposeful/semi-purposeful in 30.9% of the motor-behavioral episodes recorded. Sleeptalking was significantly more associated with purposeful/semi-purposeful motor activity than crying and/or Incomprehensible muttering (71.0% versus 21.4%, P <0.005). In 58.2% of the motor-behavioral episodes, phasic EEG-EOG events (rapid eye movements [REMs], α bursts, or sawtooth waves [STWs]) occurred simultaneously. Each variable (REMs, STWs, a bursts) was associated more with purposeful/semi- purposeful than with primitive movements (P <0.05). Conclusions: Motor-behavioral episodes in RBD were significantly more likely to occur in association with phasic than with tonic periods of REM sleep. The presence of REMs, a bursts and STWs was found to be more frequent in more complex episodes. We hypothesize that motor-behavioral episodes in RBD are likely to occur when the brain, during REM sleep, is in a state of Increased instability (presence of α bursts) and experiencing stronger stimulation of visual areas (REMs).

Original languageEnglish
Pages (from-to)241-245
Number of pages5
Issue number2
Publication statusPublished - 2009


  • A burst
  • Phasic EEG events
  • Rapid eye movements
  • REM sleep behavior disorder
  • Sawtooth wave

ASJC Scopus subject areas

  • Physiology (medical)
  • Clinical Neurology


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