Bionic Baroreflex System for Blood Pressure Control

用于血压控制的仿生压力反射系统

• 批准号: 6444469
• 负责人: Andre Diedrich
• 金额: $ 14.71万
• 依托单位: TRANSTK, INC.
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-08-15 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6444469
• 关键词: atrophy; baroreflex; bioengineering /biomedical engineering; biomedical equipment development; biophysics; blood pressure; clinical research; electronic stimulator; hereditary motor and sensory neuropathy; laboratory rat; neural degeneration; postural hypotension

DESCRIPTION (provided by applicant): Patients with multiple system atrophy (MSA), a sporadic and progressive neurodegenerative disorder, suffer from orthostatic hypotension, postprandial hypotension and supine hypertension. Hypotension causes presyncopal symptoms usually within seconds of standing and requires the patient to sit or lie down to prevent syncope. Supine hypertension reduces sleep quality through excessive nocturnal diuresis, and results in blood volume loss during the night, which aggravates orthostatic hypotension during the day. New strategies of treatments are required which take into account this cycling between hypertension and hypotension. Recent studies in our laboratory have yielded the unexpected observation that sympathetic activity is present in MSA, but is not subject to normal control mechanisms. This sympathetic activity produces inappropriate supine hypertension, but is not able to prevent the profound orthostatic hypotension. The identification of residual sympathetic activity in MSA has important implications for new therapeutic approaches. We hypothesize that a bionic baroreflex system based on electrical epidural spinal stimulation will help to replace the missing control of sympathetic activity by the vasomotor center. Preliminary data in animals showed that such a system maintained blood pressure during orthostatic stress. The purpose of this grant proposal is to search for an effective and practical bionic baroreflex system for patients with MSA and baroreflex failure. First, we will develop a prototype bionic baroreflex control system using baroreflex-denervated rats. Then, the system will be applied to control artificially, the muscle sympathetic nerve activity in patients who already have an epidural electrical stimulator in place for the control of chronic pain. A Phase II study would involve studies in animals and in patients with MSA to determine the long-term efficacy of the bionic baroreflex system in improving blood pressure control.

描述（由申请人提供）：多个系统萎缩的患者 （MSA）是一种零星和进行性神经退行性疾病，患有 体位性低血压，餐后低血压和仰卧高血压。 低血压会导致前症状前症状，通常在站立的几秒钟内 要求患者坐下或躺下以防止晕厥。仰卧高血压 通过过多的夜间利尿可降低睡眠质量，并导致 夜晚的血量损失，加剧了体位性低血压 白天。需要新的治疗策略 说明高血压和低血压之间的这种循环。 我们实验室的最新研究提出了意外的观察结果 MSA中存在同情活动，但不受正常控制 机制。这种同情活动会产生不适当的仰卧 高血压，但无法预防深刻的体位性低血压。 MSA中残留交感活动的鉴定具有重要 对新治疗方法的影响。我们假设是仿生的 基于硬膜外硬膜外脊柱刺激的压力反射系统将有助于 用血管舒适中心替换缺失的交感神经控制。 动物的初步数据表明，这种系统维持血压 在体位应力期间。该赠款提案的目的是搜索 MSA和 BaroreFlex失败。首先，我们将开发一个原型的仿生性巴罗雷诺弗莱克斯 使用压力反射的大鼠控制系统。然后，系统将是 用于人为地控制的，肌肉交感神经活动 已经有硬膜外电刺激剂的患者 控制慢性疼痛。第二阶段研究将涉及动物研究和 MSA患者以确定仿生的长期疗效 改善血压控制的压力反射系统。