Rapid eye movement (REM) sleep is a distinct behavioral state characterized by an activated cortical and hippocampal electroencephalogram (EEG) and concurrent muscle atonia. Research conducted over the past 50 years has revealed the neuronal circuits responsible for the generation and maintenance of REM sleep, as well as the pathways involved in generating the cardinal signs of REM sleep such as cortical activation and muscle atonia. The generation and maintenance of REM sleep appear to involve a widespread network in the pons and medulla. The caudal laterodorsal tegmental nucleus (cLDT) and sublaterodorsal nucleus (SLD) within the dorsolateral pons contain REM-on neurons, and the ventrolateral periaqueductal grey (vlPAG) contains REM-off neurons. The interaction between these structures is proposed to regulate REM sleep amounts. The cLDT-SLD neurons project to the basal forebrain via the parabrachial-precoeruleus (PB-PC) complex, and this pathway may be critical for the EEG activation seen during REM sleep. Descending SLD glutamatergic projections activate the ventromedial medulla, and spinal cord interneurons mediate muscle atonia and suppress phasic muscle twitches in spinal musculature. In contrast, phasic muscle twitches in the masseter muscles may be driven by glutamatergic neurons in the rostral parvicellular reticular nucleus (PCRt); however, the brain region responsible for generating phasic twitches in the other cranial muscles including facial muscles and tongue are not clear.

中文翻译：

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REM睡眠期间的肌张力调节：神经回路和临床意义。

快速眼动（REM）睡眠是一种独特的行为状态，其特征在于激活的皮质和海马脑电图（EEG）和并发的肌肉无力。在过去的50年中进行的研究表明，神经元回路负责REM睡眠的产生和维持，以及与引起REM睡眠的基本体征（例如皮层激活和肌肉萎缩）有关的途径。REM睡眠的产生和维持似乎在脑桥和延髓中涉及广泛的网络。背外侧脑桥内的尾部后背被盖核（cLDT）和背侧旁核（SLD）包含REM激活神经元，腹侧导水管周围灰色（vlPAG）包含REM禁用神经元。这些结构之间的相互作用被提议来调节REM睡眠量。cLDT-SLD神经元通过臂旁前-前结肠（PB-PC）复合体投射到基底前脑，该途径对于REM睡眠中见到的EEG激活可能至关重要。SLD的谷氨酸能投射下降会激活腹膜延髓，而脊髓中神经元介导肌肉萎缩并抑制脊髓肌肉组织中的相肌抽搐。相反，咬肌中的阶段性肌肉抽搐可能是由鸟嘴小细胞网状核（PCRt）中的谷氨酸能神经元驱动的。然而，负责其他颅内肌肉（包括面部肌肉和舌头）发生相时抽搐的大脑区域尚不清楚。SLD的谷氨酸能投射下降会激活腹膜延髓，而脊髓中神经元介导肌肉萎缩并抑制脊髓肌肉组织中的相肌抽搐。相反，咬肌中的阶段性肌肉抽搐可能是由鸟嘴小细胞网状核（PCRt）中的谷氨酸能神经元驱动的。但是，尚不清楚负责其他颅内肌肉（包括面部肌肉和舌头）发生相位抽搐的大脑区域。SLD的谷氨酸能投射下降会激活腹膜延髓，而脊髓中神经元介导肌肉萎缩并抑制脊髓肌肉组织中的相肌抽搐。相反，咬肌中的阶段性肌肉抽搐可能是由鸟嘴小细胞网状核（PCRt）中的谷氨酸能神经元驱动的。但是，尚不清楚负责其他颅内肌肉（包括面部肌肉和舌头）发生相位抽搐的大脑区域。