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April 1946

DISTURBANCES IN SLEEP MECHANISM: A CLINICOPATHOLOGIC STUDY: V. Anatomic and Neurophysiologic Considerations

Author Affiliations

NEW YORK; MEDICAL CORPS, ARMY OF THE UNITED STATES

From the Neuropsychiatric Service and the Neuropathological Laboratory of the Montefiore Hospital, and the Neurological Department of Columbia University College of Physicians and Surgeons.

Arch NeurPsych. 1946;55(4):364-381. doi:10.1001/archneurpsyc.1946.02300150068005
Abstract

ANATOMIC CONSIDERATIONS  FROM the analysis of the material in our previous communications,1 the cases reported in the literature and the results of animal experimentation, it is possible partly to reconstruct the anatomic centers and their connections regulating the sleeping mechanism.The available data suggest that certain cortical areas, namely, the frontal, premotor, motor, temporal, cingular and hippocampal (as illustrated by the cases in our presentations1; the cases in Righetti's2 collection, and the cases reported by Léchelle, Alajouanine and Thévenard,3 Kolodny,4 Frazier5 and others) may act as centers in the integration of hypersomnia and insomnia (figure). The ability of man to fall asleep voluntarily suggests that this mechanism is controlled by the higher cortical centers. Bard's6 experiments on sham rage furnished further indications that the hypothalamus is to some extent under the

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