Hallucinations and REM sleep behaviour disorder in Parkinson's disease: dream imagery intrusions and other hypotheses

REM sleep behaviour disorder (RBD) is a REM sleep-related parasomnia which may be considered a “dissociated state of wakefulness and sleep”, given that conflicting elements of REM sleep (dreaming) and of wakefulness (sustained muscle tone and movements) coexist during the episodes, leading to motor and behavioural manifestations reminiscent of an enacted dream. RBD has been reported in association with α-synucleinopathies: around a third of patients with Parkinson’s disease (PD) have full-blown RBD.Recent data indicate that PD patients with RBD are more prone to hallucinations than PD patients without this parasomnia. However it is still not clear why RBD in PD is associated with an increased prevalence of VHs.Data exist which suggest that visual hallucinations in PD may be the result of untimely intrusions of REM visual imagery into wakefulness. RBD, which is characterised by a REM sleep dissociation pattern, might be a condition that particularly favours such intrusions. However, other hypotheses may be advanced. In fact, deficits in attentional, executive, visuoperceptual and visuospatial abilities have been documented in RBD and found to occur far more frequently in PD with RBD than in PD without RBD. Neuropsychological deficits involving visual perception and attentional processes are thought to play an important role in the pathophysiology of VHs. On this basis, RBD in PD could be viewed as a contributory risk factor for VHs.     

Intersectionality,Sikhism, and Black feminist legal theory: Reconceptualizing Sikh precarity and minoritization in the US and India

ABSTRACT

Intersectionality was developed by legal scholar Kimberlé Williams Crenshaw in the late 1980s to broaden legal and epistemological frameworks for peoples at the intersection of multiple oppressions, such as racism and sexism. The theory has since proliferated and grown across many international academic and public contexts. This article examines intersectionality in Crenshaw’s original formulation to argue for theoretical and political insights when intersectionality is applied to the multiply minoritized position of Sikhs in the US and India. I argue for six theoretical formations that can illuminate what I term intersectional Sikhism: intragroup solidarity, intergroup alliances, postsecularism, untranslatability, precarity, and intellectual intersectionality.