NEURAL SITES MEDIATING OBSTRUCTIVE SLEEP APNEA

调节阻塞性睡眠呼吸暂停的神经部位

• 批准号: 6349180
• 负责人: RONALD Marven HARPER
• 金额: $ 23.08万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6349180
• 关键词: blood flow measurement; brain mapping; clinical research; electric countershock heart resuscitation; functional magnetic resonance imaging; human subject; muscle tone; oximetry; oxygen tension; psychic activity level; pulmonary respiration; sleep apnea

The objectives are to determine, using functional magnetic resonance (fMRI) techniques, the location and time course of activation of brain structures activated during obstructive sleep apnea. We hypothesize that particular regions of the orbital frontal cortex, rostral hypothalamus, amygdala, locus coeruleus, midline raphe, and dorsal and ventral pons, which activate to simulated obstructive apnea in waking control subjects, will fail to activate, or respond with reduced activity during sleep apnea events of patients, but will continue to activate during simulated obstructive apnea during sleep in controls. Other regions involved in the suppression of muscle tone may show excessive activation in patients, thereby inducing obstructive apnea. A time series of 30 repetitions of 20 image slices across the entire brain will be obtained in the sagittal plane using blood oxygen level dependent (BOLD) Echo Planar-Imaging pulse sequences, optimal for sensing perfusion alterations, in 20 obstructive apnea patients and 20 age- and sex-matched controls during apnea events of sleep (patients) and during inspiratory loads (20 cM water) applied at the onset of an inspiratory effort during sleep (controls). To partition effects of sleep, both groups will undergo a baseline waking recording, followed by inspiratory loading, and Valsalva pressor challengers, which simulate sensory and autonomic aspects of obstructive apnea. Heart rate, flow, non-invasive blood pressure, arm sweating, and digit oximetry will be measured concurrently with image scans. The MR signal changes will be assessed with software optimized for fMRI processing to gauge regional activation changes during apneic events, inspiratory loading and sympathetic challenges. Cross correlations of regional image changes with respiratory, cardiovascular and sympathetic outflow induces will be calculated. The studies have the potential to identify brain regions involved in mediating upper airway atonia, to provide insights into pharmacologic intervention for obstructive sleep apnea, and to determine the neural sites involved in autonomic concomitants of airway obstruction.

目标是使用功能磁共振确定 （fMRI）技术，大脑激活的位置和时间过程 在阻塞性睡眠呼吸暂停期间激活的结构。我们假设这一点 轨道额叶皮质的特定区域，下丘脑和 杏仁核，基因座，中线raphe，背侧和腹桥， 在醒来的控制受试者中激活以模拟阻塞性呼吸暂停， 在睡眠呼吸暂停期间的活动减少或响应 患者的事件，但在模拟过程中将继续激活 在对照中睡眠期间的阻塞性呼吸暂停。涉及的其他地区 抑制肌肉张力可能显示患者过度激活， 从而诱导阻塞性呼吸暂停。 30次重复的时间序列20 将在矢状中获得整个大脑的图像切片 平面使用血氧水平依赖（粗体）回波平面成像脉冲 在20个阻塞性中，序列，最佳感测灌注改变 在呼吸暂停事件期间，呼吸暂停患者以及20岁和性别匹配的对照 睡眠（患者）和在吸气载荷（20厘米水）时 睡眠期间的灵感努力发作（对照）。分区 睡眠的影响，两组将经历基线醒来的记录， 其次是Insperatory Loading和Valsalva pertor挑战者，这是 模拟阻塞性呼吸暂停的感觉和自主方面。心率， 流动，非侵入性血压，手臂出汗和数字血氧仪将会 通过图像扫描同时测量。 MR信号更改将是 用针对fMRI处理的软件进行评估以评估区域 呼吸暂停期间的激活变化，吸气加载和 同情挑战。 区域图像的互相关与 呼吸道，心血管和交感神经流出诱导将是 计算。这些研究有可能识别大脑区域 参与调解上呼吸道Atonia，以提供见解 用于阻塞性睡眠呼吸暂停的药理干预措施，并确定 涉及气道阻塞的自主神经伴侣的神经部位。