Sleep and wake mediators as laboratory biomarkers of post-stroke hypersomnolence (literature review)

The article presents current data on the role of neurotransmitter systems in the regulation of the sleep-wake cycle. The basic principles of the functioning of the systems of awakening, NREM and REM sleep are considered, the leading mediators of sleep and wakefulness (melatonin, orexins, GABA, glutamate, norepinephrine, histamine, dopamine, serotonin, acetylcholine) are characterized. Given the high relevance of prevention of stroke complications and the proven relationship between acute cerebrovascular accident and hypersomnolence spectrum disorders, the results of the analysis of modern studies on the problem of hypersomnolence biomarkers are presented. The role of some mediators involved in the regulation of the processes of sleep and wakefulness remains not fully understood, which allows us to consider them as potential biomarkers of hypersomnolence. Possible contenders are orexin-A, glutamate and GABA, also acetylcholine. This article provides a review of the currently available literature on laboratory markers of hypersomnolence and the possibilities of their assessment in patients with acute ischemic stroke.

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