Assessment of Upper Airway Mechanics Using Newer Electromyographic Techniques

 描述(由申请人提供)：将新的肌电技术应用于上呼吸道肌肉，以期确定阻塞性睡眠呼吸暂停的重要治疗靶点。职业发展目标：为学员的指导和研究活动提供充足的时间。研究项目：阻塞性睡眠呼吸暂停是一种重要疾病，因其发病率高，且有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，要么疗效不同，导致许多人倡导对潜在机制进行进一步研究。先前的研究已经确定了上呼吸道肌肉(如颧舌肌和腭张肌)在睡眠呼吸暂停的发病机制中的重要性。然而，多单位肌电记录提供了无数运动单位的平均表示，产生了关于单个运动单位行为的相当不完整的信息。我们目前有R01资金用于对肌电进行高频采样，以确定颧舌肌内的各种运动单位。这些较新的研究揭示了颧舌肌行为的显著复杂性，可识别出6种不同的放电模式。因此，颧舌多单位肌电的上升或下降很难解释，因为这些变化可以由许多单独的运动单位放电变化中的任何一个来调节。我们观察到了可能对维持咽部通畅最为关键的特定单位。因此，这样的单元将成为我们可以与神经解剖学合作者解决的合理治疗目标。我们还开始了使用单纤维肌电图仪和宏观肌电图仪的研究，以期对各种上呼吸道肌肉进行更多的定量评估。我们将利用K24基金专注于R01的临床相关发现，这样最终临床医生将能够定义上呼吸道运动功能，而不需要复杂或侵入性的生理测试。这一K24奖项将使我们能够继续进行有趣的假设，最终可能导致针对睡眠呼吸暂停的新的易于应用的治疗方法。这一奖项还将允许PI通过减少临床责任，将更多时间用于培训睡眠和呼吸生理学领域的年轻研究人员。对调查人员管道的需要被称为一场危机(睡眠)。2006年29：1260)，国际和平协会希望通过他的研究和对受训者的奉献精神继续解决这个问题。

 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.