Researchers ID Neurons in Mouse Brainstem that Suppress Movement During REM Sleep. It Could Be a Treatment Target for RBD, Narcolepsy, & Cataplexy.

Rapid eye movement (REM) sleep correlates when we dream. Our eyes move back and forth, but our bodies remain still. This near-paralysis of muscles while dreaming is called REM-atonia, and it is lacking in people with REM sleep behavior disorder. Instead of being still during REM sleep, muscles move around, often going as far as to stand up and jump, yell, or punch. Researchers at the University of Tsukuba led by Takeshi Sakurai, PhD, and his team set out to find the neurons in the brain that normally prevent this type of behavior during REM sleep.

Working with mice, the researchers found are neurons in the brain that are likely candidates. They say these neurons also impact narcolepsy and cataplexy could provide a target for treatments of narcolepsy and REM sleep behavior disorder.

These cells were located in an area of the brain called the ventral medial medulla and received input from another area called the sublaterodorsal tegmental nucleus, or SLD.

“The anatomy of the neurons we found matched what we know,” Sakurai says in a release. “They were connected to neurons that control voluntary movements, but not those that control muscles in the eyes or internal organs. Importantly, they were inhibitory, meaning that they can prevent muscle movement when active.”

When the researchers blocked the input to these neurons, the mice began moving during their sleep, just like someone with REM sleep behavior disorder.

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Sakurai and his team suspected that the special neurons they found were related to narcolepsy with cataplexy. They tested their hypothesis using a mouse model of narcolepsy in which cataplexic attacks could be triggered by chocolate. “We found that silencing the SLD-to-ventral medial medulla reduced the number of cataplexic bouts,” says Sakurai.

Overall, the experiments showed these special circuits control muscle atonia in both REM sleep and cataplexy. “The glycinergic neurons we have identified in the ventral medial medulla could be a good target for drug therapies for people with narcolepsy, cataplexy, or REM sleep behavior disorder,” says Sakurai. “Future studies will have to examine how emotions, which are known to trigger cataplexy, can affect these neurons.”