Hi everyone:
The last couple of topics have covered some areas of research that I help with at UA, so I thought it would be interesting to blog about them.
We study the neurological control of upper respiratory muscles in healthy individuals as well as certain disease states. As a primary clinical interest we want to investigate the pathophysiology of obstructive sleep apnea (OSA), since there are several other severe, multi-system complications that can arise from OSA including metabolic issues, cardiovascular problems and neurological dysfunction, either arising from a lack of proper sleep architecture or improper oxygenation. OSA is more common in obese individuals, but not exclusively. People with underlying neurological or psychological conditions are at a greater risk, as well as menopausal women.
For awhile we were studying the respiratory muscle functions of a man with Parkinson's Disease (PD) that was being treated for it using a deep-brain stimulator. We were able to turn off his stimulator for the trials, and the difference in symptom manifestation was remarkable. His tremors literally would start and stop like a switch was being flipped. He said that the therapy had changed his life, though it wasn’t perfect. He was willing to trade infrequent nausea for the ability to eat a bowl of cereal on his own or to tie his shoes without help.
Deep brain stimulation, also known as a "brain pacemaker," has been used for quite some time, though the underlying mechanisms of function are unclear. Anytime we hear that kind of description for a therapy, we want to try and investigate possible side effects, particularly respiratory side effects. We were getting inconclusive and inconsistent recordings from our PD patient, and eventually noticed that he was dozing in and out while we were taking muscle recordings. This is a very common sign of poor sleep, and because of the patient's age we figured he hadn't been pulling any all-nighters or drinking huge amounts of caffeine like a college student, so we started trying to get some background information on his sleep history.
He claimed that he actually slept fairly well, but that his wife complained about his snoring. Snoring is generally an indicator of OSA, so we got some more information. He had been taking Requip, which is a drug used to treat Restless Leg Syndrome. RLS is a condition commonly associated with PD, though some researchers question whether or not it is actually a unique condition or a manifestation of other disease conditions. Some ongoing research suggests that pharmacological treatment of RLS can exacerbate the condition for people with PD, and other research has demonstrated a potential link between RLS and sleep apnea. He also was taking preventative Aspirin therapy, and occasionally took sleep aids because he felt tired during the day. At this point we realized that we weren't going to be able to use this guy as a subject, because there were so many things potentially interfering with his respiratory cycle.
I found it very interesting that “polypharmacy” had been associated with other inflammation state treatments, since we potentially ran into this problem doing neurophysiology research. Consideration of these neurologic conditions as inflammation states is a promising step towards furthering our neurophysiological research.
http://www.mayoclinic.com/health/restless-legs-syndrome/DS00191
http://restless-legs-syndrome.emedtv.com/requip/requip-side-effects.html
http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm
No comments:
Post a Comment