Assessment of Upper Airway Mechanics Using Newer EMG Techniques

使用更新的肌电图技术评估上呼吸道力学

• 批准号: 8502737
• 负责人: Atul Malhotra
• 金额: $ 1.33万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8502737
• 关键词: Address; Advocate; Affect; Animals; Arousal; Award; Behavior; Behavioral; Breathing; Carbon Dioxide; Cardiovascular system; Chemical Stimulation; Data; Deglutition; Denervation; Development; Dilator; Disease; Drops; Environmental air flow; Fiber; Frequencies; Goals; High Prevalence; Human; Hypercapnia; Hypertension; Individual; Instruction; Iron; Lead; Lung; Maintenance; Mechanical Stimulation; Mechanics; Mediating; Mentors; Methods; Mid-Career Clinical Scientist Award (K24); Modeling; Motor; Muscle; Neuroanatomy; Neurocognitive; Obstructive Sleep Apnea; Pathogenesis; Patients; Pattern; Phase; Principal Investigator; REM Sleep; Recruitment Activity; Research; Research Activity; Research Personnel; Research Project Grants; Respiratory physiology; Role; Sampling; Series; Sleep; Sleep Apnea Syndromes; Source; Stimulus; Stroke; Techniques; Testing; Time; Tongue; Training; Trigeminal Nuclei; Wakefulness; Withdrawal; Work; awake; base; career development; density; falls; improved; insight; interest; motor control; neuroregulation; new therapeutic target; novel strategies; pressure; prevent; programs; reinnervation; relating to nervous system; research study; respiratory; response; sleep onset; therapeutic target; vehicular accident

Program Director/Principal Investigator (Last, First, Middle): Malhotra, Atul, MD PROJECT SUMMARY (Seeinstructions): Immediate goals: To apply newer electromyographic techniques to upper airway muscles with a view towards identifying important therapeutic targets in obstructive sleep apnea. Career development goals: To provide sufficient time for mentoring of trainees and research activities. Research project: Obstructive sleep apnea is an important disease due to its high prevalence and well established neurocognitive and cardiovascular sequelae. Treatment of this disease remains problematic since the existing therapies are either poorly tolerated or have variable efficacy, leading many to advocate for further research into underlying mechanisms. Prior research has established in the importance of the upper airway muscles (such as the genioglossus and tensor palatini) in the pathogenesis of sleep apnea. However, multi-unit electromyographic recordings provide an average representation of innumerable motor units yielding fairly incomplete information about the behavior of individual motor units. We have begun a series of studies using high frequency sampling of the electromyogram to define the various motor units within the genioglossus muscle. These newer studies have revealed marked complexity in the behavior of the genioglossus muscle, with 6 distinct firing patterns being identifiable. A rise or fall in the genioglossal multiunit EMG is therefore difficult to interpret since these changes could be mediated by any of a number of individual motor unit firing changes. We have observed specific units that may be most critical for the maintenance of pharyngeal patency. Such units would thus we logical therapeutic targets which we can address with our neuroanatomy collaborators. We have also begun studies using single fiber EMGs and MacroEMGs which a view towards performing more quantitative assessments of various upper airway muscles. These newer EMG techniques will allow us to assess the mechanisms underlying the high level of activity seen in the EMG of sleep apnea patients as compared with controls, since there is currently an ongoing controversy as to whether this high activity represents high central drive to the muscle versus an effect of denervation. This K24 award would allow us to pursue interesting hypotheses that may ultimately lead to new treatments for sleep apnea, but will certainly yield insights into disease pathogenesis. This award will also allow the PI to dedicate more time to training young investigators in the field of sleep and respiratory physiology. The need for an investigator pipeline has been termed a crisis (Sleep. 2006 29:1260) RELEVANCE (See instructions): Obstructive sleep apnea is strongly implicated in motor vehicle accidents as well as high blood pressure and stroke. How easily an individual wakes up from sleep (arousal threshold) is something that may be important in why sleep apnea occurs. We propose studies that will examine the role of the arousal threshold with an ultimate goal of developing new treatments for sleep apnea to prevent its serious complications. PROJECT/

项目负责人/主要研究者（最后一名、第一名、中间名）：Malhotra，Atul，MD 项目总结（见说明）： 近期目标：将更新的肌电图技术应用于上气道肌肉， 以确定阻塞性睡眠呼吸暂停的重要治疗目标。职业发展目标： 为学员提供充足的指导和研究活动时间。研究项目：阻碍性 睡眠呼吸暂停是一种重要的疾病，这是由于其高患病率和良好的神经认知， 心血管后遗症这种疾病的治疗仍然是有问题的，因为现有的治疗方法 要么耐受性差，要么疗效不一，导致许多人主张进一步研究， 基本机制。先前的研究已经确立了上呼吸道肌肉的重要性 (such如颏舌肌和腭张肌）在睡眠呼吸暂停发病机制中的作用。然而，多单位 肌电图记录提供了无数运动单位的平均表示， 关于单个运动单位行为的不完整信息。我们已经开始了一系列的研究 使用肌电的高频采样来定义肌内的各种运动单位 颏舌肌这些较新的研究揭示了在行为的显着复杂性， 颏舌肌，可识别6种不同的放电模式。颏舌肌的起伏 因此，多单位EMG难以解释，因为这些变化可以由许多 个体的运动单元放电变化。我们已经观察到了可能对我们最重要的特定单位。 保持咽部通畅。因此，这些单位将是我们可以合理治疗的目标， 与我们的神经解剖学合作者讨论。我们还开始使用单纤维肌电图进行研究， MacroEMG旨在对各种上呼吸道进行更定量的评估 肌肉.这些较新的肌电图技术将使我们能够评估高水平的肌张力的机制。 与对照组相比，在睡眠呼吸暂停患者的EMG中观察到的活动，因为目前有一种 关于这种高活性是否代表肌肉的高中枢驱动， 去神经的影响。这个K24奖将使我们能够追求有趣的假设， 导致睡眠呼吸暂停的新疗法，但肯定会产生对疾病发病机制的见解。这 该奖项还将使PI能够投入更多的时间来培训睡眠领域的年轻研究人员， 呼吸生理学对调查人员管道的需求被称为危机（睡眠。2006 29：1260） 相关性（参见说明）： 阻塞性睡眠呼吸暂停与机动车事故以及高血压和 中风一个人从睡眠中醒来的容易程度（觉醒阈值）可能很重要 睡眠呼吸暂停综合征的病因我们提出的研究将检查唤醒阈值的作用， 最终目标是开发睡眠呼吸暂停的新疗法，以防止其严重并发症。 项目/