1/3/2024 0 Comments Arq awning review![]() We examined 161 patients with acute middle cerebral artery stroke who were consecutively admitted to emergency department. We aimed to determine whether PY is a prognostic marker of middle cerebral artery (MCA) stroke and evaluate its relationship with the infarct location. PY could also be seen in the course of ischemic stroke. It may be related to iatrogenic, neurologic, psychiatric, gastrointestinal or metabolic disorders. Pathological yawning (PY) is a compulsive, frequent, repetetive yawning triggered by a specific reason besides fatigue or boredom. Although PY in brainstem and anterior circulation ischemic stroke has been previously reported in the literature, to date, the exact mechanism of cortical network remains to be established by functional neuroimaging studies. PY has been reported in numerous neurological conditions including parkinsonism, Parkinson's disease, progressive supranuclear palsy, Huntington disease, myasthenia gravis, bulbar amyotrophic lateral sclerosis, multiple sclerosis, neuromyelitis optica spectrum disorders, migraine aura, vasovagal syncope, narcolepsy, brain tumor, encephalitis, intracranial hypertension, stroke, Chiari malformation type I, epilepsy, stress, and anxiety disorders (6,(9)(10)(11)(12) (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Besides the physiological factors such as fatigue, boredom, or contagion pathological yawning (PY) is found to be triggered by various iatrogenic causes and several metabolic, gastrointestinal, psychiatric, or neurological diseases (9)(10)(11)(12). Aberrant cholinergic/noradrenergic transmission between these brainstem nuclei early in PD couldlead to tremor before the emergence of other parkinsonian signs, representing an early clinical clue to prodromal PD. The PVN is affected in PD and evidence from related phenomena suggest that the PVN could increase tremor either by increasing downstream cholinergic activity on brainstem nuclei such as the reticular formation or by stimulating the locus ceruleus to activate the cerebellothalamocortical network via the ventrolateral nucleus of the thalamus. The hypothalamic paraventricular nucleus (PVN) plays a central role in autonomic control including bowel/bladder function, cardiovascular homeostasis and yawning and innervates multiple brainstem nuclei involved in autonomic functions (including brainstem reticular formation, locus ceruleus, dorsal raphe nucleus and motor nucleus of the vagus). ![]() ![]() We present a series of patients who, in the prodromal phase of PD, experienced the emergence of tremor initially only while yawning or straining at stool and discuss how early involvement of autonomic brainstem nuclei could lead to these previously unreported phenomena. Furthermore, subtle motor signs may be present and emerge prior to the time of diagnosis. Some people with PD describe autonomic symptoms at the time of diagnosis suggesting that autonomic dysfunction is a common feature of prodromal PD. Since disease-modifying treatments are likely to be most effective when initiated early in the disease process, there has been significant interest in characterizing prodromal PD. Una sintesi dei risultati sperimentali e delle formulazioni teoriche che si sono accumulate negli ultimi anni nello studio dello sbadiglio, mettendo in luce la difficoltà nel ricondurre la complessità manifestata da questo comportamento ad un’unica spiegazioneĬlinical, neuropathological and neuroimaging research suggests that pathological changes in Parkinson’s disease (PD) start many years before the emergence of motor signs. (respiratoria, legata alla regolazione dell’arousal, termoregolatoria e vincolata ai livelli diĬortisolo ematico) o sociale-comunicativa attribuita allo sbadiglio. Ipotesi ciascuna delle quali attribuisce un ruolo primario ad una funzione fisiologica In particolare, sono state avanzate diverse Volte a spiegare la sua origine filogenetica. A fronte di questi avanzamenti, la discussione sulle potenziali funzioni svolte dallo sbadiglio è ancora aperta e continuano ad emergere teorie alternative La ricerca ha messo in evidenza le condizioni aĬui si associa una variazione della sua frequenza, i meccanismi neurofisiologici e patologici che lo regolano. Negli ultimi decenni si è assistito ad un crescente interesse verso un comportamento a lungo ignorato, lo sbadiglio.
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