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NEUROLOGY 2004;63:S2-S7
© 2004 American Academy of Neurology

Neurology supplements are not peer-reviewed. Information contained in Neurology supplements represent the opinions of the authors and are not endorsed by nor do they reflect the views of the American Academy of Neurology, Editor-in-Chief, or Associate Editors of Neurology.

The two faces of Eve

Dopamine’s modulation of wakefulness and sleep

David B. Rye, MD PhD

From the Department of Neurology, Emory Healthcare Program in Sleep Medicine, Emory University School of Medicine, Atlanta, Georgia.

Address correspondence and reprint requests to Dr. David B. Rye, Department of Neurology, Emory Healthcare Program in Sleep Medicine, Emory University School of Medicine, 101 Woodruff Circle, Suite 6000, Atlanta, GA 30322; e-mail drye{at}emory.edu

In Parkinson’s disease (PD), waking is frequently punctuated by sleep episodes, including rapid eye movement (REM) (i.e., dream) sleep, and sleep is interrupted by motor activities such as periodic limb movements and REM sleep behavior disorder. Because these pathologic behaviors are unaccounted for by contemporary models, this review summarizes the complex effects of dopamine (DA) on normal and pathological waking–sleeping. Maintenance of wakefulness is probably promoted by mesocorticolimbic DA circuits, and suppression of nocturnal movement appears to be influenced by indirect pathways linking midbrain DA neurons with pre-motor structures in the mesopontine tegmentum and ventromedial medulla. A diencephalospinal DA system may have an additional important role in mediating state-specific sensorimotor activity that is relevant to periodic limb movements and restless legs syndrome.




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