Brainstem Mechanisms of Dreaming and of Disorders of Sleep in Man

Abstract

This chapter discusses examples of clinical disorders (Sections 13.1 and 13.2) and of the mental activity during REM sleep (dreaming, Section 13.3) that are directly related to brainstem control of behavioral state. The intent is to provide a two-way bridge between basic neuroscience investigations of brainstem function and knowledge of characteristics of human pathology and mental activity in REM sleep. We have accordingly attempted to phrase the discussion so as to be accessible to both the neuroscientist and the clinician. The cognitive phenomenology and the clinical disorders surveyed have been selected because they form excellent “case examples” of the interplay of clinical and research domains. We have further chosen the clinical pathological examples because they represent examples of the diverse roles of cholinergic and monoaminergic modulatory systems. The chapter follows the paradigm of having an “explanation” of the clinical data by models and data derived from more basic neuroscience research, and the clinical data serve as a benchmark for measuring adequacy and accuracy of the basic science explanations.