Assessment of Upper Airway Mechanics Using Newer Electromyographic Techniques

 描述（由申请人提供）：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靶点。职业发展目标：提供足够的时间指导学员和研究活动。研究项目：阻塞性睡眠呼吸暂停是一种重要的疾病，由于其高患病率和公认的神经认知和心血管后遗症。这种疾病的治疗仍然存在问题，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潜在的机制。先前的研究已经确定了上气道肌肉（如颏舌肌和腭张肌）在睡眠呼吸暂停发病机制中的重要性。然而，多单位肌电图记录提供了无数运动单位的平均表示，产生关于单个运动单位的行为的相当不完整的信息。我们目前有R01基金来执行肌电图的高频采样，以定义颏舌肌内的各种运动单位。这些新的研究揭示了颏舌肌行为的显着复杂性，可识别6种不同的放电模式。因此，颏舌肌多单位EMG的上升或下降很难解释，因为这些变化可能由许多单独的运动单位放电变化中的任何一个介导。我们已经观察到特定的单位，这可能是最关键的维持咽通畅。因此，这些单位是我们可以与我们的神经解剖学合作者一起解决的逻辑治疗目标。我们也开始了使用单纤维肌电图和宏肌电图的研究，旨在对各种上呼吸道肌肉进行更定量的评估。我们将利用K24资金专注于R01的临床相关发现，以便最终临床医生能够在不需要复杂或侵入性生理学测试的情况下定义上气道运动功能。这个K24奖项将使我们能够追求有趣的假设，最终可能导致新的容易适用的治疗睡眠呼吸暂停。该奖项还将允许PI通过减少其临床责任，将更多时间用于培训睡眠和呼吸生理学领域的年轻研究者。对调查人员管道的需求被称为危机（睡眠。2006 29：1260），PI希望继续通过他的研究和他对学员的奉献来解决这些问题。

 DESCRIPTION (provided by applicant): 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 current R01 funding to perform 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 which 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. We will use the K24 funding to focus on clinically relevant findings from the R01 such that ultimately clinicians will be able to define upper airway motor function without the need for complex or invasive physiology testing. This K24 award would allow us to pursue interesting hypotheses which may ultimately lead to new easily applicable treatments for sleep apnea. This award will also allow the PI to dedicate more time to training young investigators in the field of sleep and respiratory physiology by reducing his clinical responsibilities. The need for an investigator pipeline has been termed a crisis (Sleep. 2006 29:1260) which the PI would like to continue to address through his research and his dedication to his trainees.