Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101071
Kazuo Mishima
{"title":"[Dementia and Sleep: A Bidirectional Relationship].","authors":"Kazuo Mishima","doi":"10.11477/mf.188160960770101071","DOIUrl":"https://doi.org/10.11477/mf.188160960770101071","url":null,"abstract":"<p><p>Sleep-waking is regulated by numerous sleep- and wake-promoting nuclei in the brain and biological clocks (suprachiasmatic nucleus). In dementia, organic damage occurs in the brainstem, hypothalamus, and thalamus, where these nuclei and their neural projections are concentrated, resulting in severe insomnia, hypersomnia, and irregular sleep-wake patterns. Numerous cohort studies have strongly suggested that sleep disturbances, such as impaired sleep quality and hypersomnia, may serve as early indicators or risk factors for the onset of dementia. Until recently, the neuropathological mechanisms underlying the association between sleep disturbance and the risk of dementia remained unclear. However, recent advances in research on the glymphatic system and its association with amyloid-beta peptide clearance have begun to elucidate this missing link.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1071-1077"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101053
Ayano Watanabe, Takeshi Sakurai
{"title":"[Neural Circuit Mechanisms Underlying REM Sleep].","authors":"Ayano Watanabe, Takeshi Sakurai","doi":"10.11477/mf.188160960770101053","DOIUrl":"https://doi.org/10.11477/mf.188160960770101053","url":null,"abstract":"<p><p>Rapid eye movement (REM) sleep is characterized by an \"active brain\" and an \"immobile body,\" and its dysregulation has been implicated in disorders such as narcolepsy and REM sleep behavior disorder. In this review, we first provide an overview of the basic features of REM sleep and then introduce the mechanisms by which dopamine signaling in the amygdala induces REM sleep and the inhibitory pathways in the medulla oblongata that mediate muscle atonia. Finally, we discussed how an integrated understanding of these neural circuits will advance our knowledge of the pathophysiology of sleep-related disorders and inform future therapeutic strategies.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1053-1057"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101065
Takuya Oguri
{"title":"[Assessment of Sleep-Related Disorders].","authors":"Takuya Oguri","doi":"10.11477/mf.188160960770101065","DOIUrl":"https://doi.org/10.11477/mf.188160960770101065","url":null,"abstract":"<p><p>This review outlines commonly used self-reporting tools and sleep-related tests for the diagnosis and management of sleep-related disorders. In clinical practice, it is essential to identify multiple potential contributing factors based on the patient's chief complaints and select the most appropriate assessment method accordingly. Each assessment method has its strengths and limitations that must be carefully evaluated when interpreting the results. Notably, while simpler tools offer convenience, their effective clinical use requires a higher level of literacy in sleep physiology and understanding of the characteristics of the measurement devices to ensure appropriate clinical application and result interpretation.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1065-1070"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101117
Taisuke Ono, Takashi Kanbayashi
{"title":"[Pathophysiology of Narcolepsy].","authors":"Taisuke Ono, Takashi Kanbayashi","doi":"10.11477/mf.188160960770101117","DOIUrl":"https://doi.org/10.11477/mf.188160960770101117","url":null,"abstract":"<p><p>Narcolepsy is primarily characterized by excessive daytime sleepiness, which is the cardinal symptom. Additional associated symptoms include cataplexy, sleep paralysis, hypnagogic hallucinations, and nocturnal sleep fragmentation. Narcolepsy is classified into two subtypes: type 1, which is caused by the loss of orexin-producing neurons, and type 2, the pathophysiology of which remains unclear. Currently, no curative treatment exists; management is limited to symptomatic therapies. Recently, orexin receptor agonists have been developed and are undergoing evaluation in clinical trials.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1117-1120"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Symptomatic Narcolepsy due to Neurological Disorders].","authors":"Keisuke Suzuki, Hiroaki Fujita, Ryoma Takahashi, Masashi Kashiwagi","doi":"10.11477/mf.188160960770101121","DOIUrl":"https://doi.org/10.11477/mf.188160960770101121","url":null,"abstract":"<p><p>Narcolepsy is a major central disorder of hypersomnolence that causes excessive daytime sleepiness (EDS), cataplexy, sleep paralysis and hypnagogic hallucinations due to impairment of the orexinergic system. Symptomatic narcolepsy is characterized by persistent EDS and REM sleep-related symptoms due to associated neurological diseases or brain lesions. Hypothalamic lesions due to neurological disorders, including immune-mediated diseases, can cause symptomatic narcolepsy. This review describes symptomatic narcolepsy and EDS associated with neurological disorders.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1121-1126"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101059
Noriaki Sakai
{"title":"[Sleep and Cerebrospinal Fluid].","authors":"Noriaki Sakai","doi":"10.11477/mf.188160960770101059","DOIUrl":"https://doi.org/10.11477/mf.188160960770101059","url":null,"abstract":"<p><p>The discovery of the glymphatic system, a waste clearance pathway in the brain, has drawn increasing attention to the relationship between sleep and neurological diseases such as Alzheimer's disease. Recent studies have revealed the mechanisms of action during sleep in rodents. However, some aspects remain unclear, including their contribution to aging and disease development, and their potential for prevention and early therapeutic intervention.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1059-1064"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101111
Yoshio Tsuboi
{"title":"[Restless Legs Syndrome].","authors":"Yoshio Tsuboi","doi":"10.11477/mf.188160960770101111","DOIUrl":"https://doi.org/10.11477/mf.188160960770101111","url":null,"abstract":"<p><p>Restless leg syndrome (RLS) is a sensorimotor disorder characterized by unpleasant sensations in the lower limbs and an urge to move them, which often results in insomnia or difficulty in maintaining sleep. Although RLS is less prevalent in Asian populations than in Western countries, it remains common and often underdiagnosed. The diagnosis is based on international consensus criteria, and its pathophysiology is thought to involve central dopaminergic dysfunction and impaired iron metabolism in the brain. Management strategies include iron supplementation, lifestyle, and pharmacological treatment using dopamine agonists and α2δ ligands. However, drug-induced augmentation remains challenging. The 2024 clinical guidelines published by the Japanese Society of Neurological Therapeutics provide evidence-based recommendations and a treatment algorithm addressing both standard therapy and augmentation. This review summarizes the current knowledge on the epidemiology, diagnosis, pathophysiology, and treatment of RLS, with a focus on the implications of the new guidelines.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1111-1115"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101079
Yoya Ono, Akio Kimura, Takayoshi Shimohata
{"title":"[Autoimmune Encephalitis and Associated Sleep Disorders].","authors":"Yoya Ono, Akio Kimura, Takayoshi Shimohata","doi":"10.11477/mf.188160960770101079","DOIUrl":"https://doi.org/10.11477/mf.188160960770101079","url":null,"abstract":"<p><p>Autoimmune encephalitis can cause various sleep disorders. Anti-NMDAR encephalitis often presents with insomnia in the acute phase, which may transition into hypersomnia or confusional arousal during recovery. Anti-LGI1 and anti-CASPR2 encephalitis can also cause Morvan's syndrome. This syndrome is characterized by blurred distinctions between sleep stages, leading to status dissociatus and agrypnia excitata. Anti-IgLON5 disease is associated with parasomnia, sleep apnea, and stridor, all of which can lead to sudden death. NMOSD and anti-Ma2 encephalitis may present as narcolepsy accompanied by hypothalamic lesions, likely due to orexin deficiency.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1079-1085"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Significance of Amyloid Plaque Removal in Alzheimer's Disease Treatment: Development of Amyloid β-Targeting Antibody Drugs Based on the Amyloid Cascade Hypothesis].","authors":"Hisatomo Kowa, Shoichiro Sato, Eriko Kamiki, Takaaki Nishimoto","doi":"10.11477/mf.188160960770101129","DOIUrl":"https://doi.org/10.11477/mf.188160960770101129","url":null,"abstract":"<p><p>In a hyper-aging society, taking measures against dementia, especially against dementia due to Alzheimer's disease, which accounts for about two thirds of dementia cases, is an important task socially and economically. Forty years have passed since amyloid β was isolated from a patient, 30 years have passed since the amyloid cascade hypothesis was proposed and antibody drugs based on this hypothesis have emerged, which has led to the new era of Alzheimer's disease treatment. This article reviews the significance of amyloid plaque removal with amyloid β-targeting antibody treatment for Alzheimer's disease. (Recieved October 17, 2024; Accepted June 6, 2025; Published October 1, 2025).</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1129-1136"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain and NervePub Date : 2025-10-01DOI: 10.11477/mf.188160960770101095
Hideaki Nakayama
{"title":"[Multiple System Atrophy and Sleep-Related Breathing Disorders].","authors":"Hideaki Nakayama","doi":"10.11477/mf.188160960770101095","DOIUrl":"https://doi.org/10.11477/mf.188160960770101095","url":null,"abstract":"<p><p>Multiple system atrophy (MSA) is a sporadic, progressive neurodegenerative disease that affects multiple systems, including the Parkinsonian and cerebellar systems. It is commonly associated with obstructive and central sleep apnea, sleep-related hypoventilation, and stridor, which may evolve with changes in the disease phenotype and severity. These respiratory complications are considered potential causes of sudden death, making the critical importance of their evaluation and management in patients with MSA. However, no established treatment has been developed, and therapeutic approaches, such as continuous positive airway pressure (CPAP) or tracheostomy, have been attempted on a case-by-case basis.</p>","PeriodicalId":52507,"journal":{"name":"Brain and Nerve","volume":"77 10","pages":"1095-1099"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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