PulseTrendingJournal ClubResearchersJournalsExplore
Instagram
HomeTrendingJournal ClubExplore
Synapse
⌘+K
Synapse
May 26, 2021Frontiers in PhysiologyOpen Access

Comparison of Cortical Autonomic Network-Linked Sympathetic Excitation by Mueller Maneuvers and Breath-Holds in Subjects With and Without Obstructive Sleep Apnea

View Full Paper
Ask AI
Bookmark
Share

Why the study?

It was hypothesized that Mueller maneuvers and breath-holds would elicit greater concomitant changes in mean efferent nerve firing and BOLD signal intensity in patients with moderate to severe OSA compared with controls.

Do Mueller maneuvers and breath-holds elicit greater changes in MSNA and BOLD signal intensity in patients with moderate to severe OSA compared to those without?

Comparison

Patients with moderate to severe OSA vs age- and sex-matched individuals with no or mild OSA

Design

Physiological study with maneuvers performed in randomly assigned order

Key result

Mueller maneuvers and breath-holds elicited similar muscle sympathetic nerve activity and cortical BOLD signal responses in subjects with and without moderate to severe obstructive sleep apnea.

Authors

KTKeri S. TaylorMount Sinai HospitalDKDaniel A. KeirPreventive CardiologyNHNobuhiko HarukiMount Sinai Hospital

Discussion

Loading...

Member takes

Overview

Neural responses to simulated apnea are similar in OSA and controls; leaves open mechanisms of sympathetic dysregulation in sleep apnea.

Study Design

Type

Observational (n=46)

Blinding

Blinded analysis

Randomization

Randomized task order

Multicenter

No

Structured PICO

Do Mueller maneuvers and breath-holds elicit greater changes in MSNA and BOLD signal intensity in patients with moderate to severe OSA compared to those without?

P
Population
46 participants, 24 with moderate to severe obstructive sleep apnea (OSA) [mean age 59 ± 8 years; AHI 31 ± 18 events/h; 7 women] and 22 without or with mild OSA [mean age 58 ± 11 years; AHI 7 ± 4 events/h; 9 women].
I
Intervention
Simulation of obstructive or central sleep apnea via Mueller maneuvers (MM) and breath-holds (BH) during continuous recording of muscle sympathetic nerve activity (MSNA) and functional MR imaging.
C
Comparator
Age- and sex-matched individuals with no or only mild OSA (AHI <15 events/h) performing the same maneuvers.
O
Outcome
Concomitant changes in mean efferent nerve firing (MSNA) and BOLD signal intensity in cortical cardiovascular autonomic regions.surrogate

Main Result

p-value: p=0.13

Recurring episodes of cyclical apnea during sleep do not appear to alter cortical or peripheral neural responsiveness to simulated apnea during wakefulness.

Limitations

  • Brief duration of volitional stimuli (15 s) compared to spontaneous apnea
  • Experiments were conducted during wakefulness rather than sleep
  • Older age of participants may have constrained dynamic range of BOLD signals
  • Head movement artifacts excluded nearly half the participants from fMRI analysis

Cite This Study

Taylor et al. (2021) conducted an observational in Obstructive Sleep Apnea (n=46). Mueller maneuvers and breath-holds vs. Subjects without moderate to severe OSA was evaluated on Between-group differences in muscle sympathetic nerve activity (MSNA) burst incidence during breath-holds (p=0.13). Mueller maneuvers and breath-holds elicited similar muscle sympathetic nerve activity and cortical BOLD signal responses in subjects with and without moderate to severe obstructive sleep apnea.

synapsesocial.com/papers/6a12e85013ab6312a8c0b33bhttps://doi.org/10.3389/fphys.2021.678630
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Apnea-Induced Cortical BOLD-fMRI and Peripheral Sympathoneural Firing Response Patterns of Awake Healthy Humans2013 · 37 citations
  2. 2Augmented sympathetic neural response to simulated obstructive apnoea in human heart failure2003 · 41 citations
  3. 3Surges of muscle sympathetic nerve activity during obstructive apnea are linked to hypoxemia1995 · 277 citations
  4. 4Muscle Metaboreflex Control of Sympathetic Activity in Obstructive Sleep Apnea2017 · 24 citations
  5. 5Cortical autonomic network gray matter and sympathetic nerve activity in obstructive sleep apnea2017 · 53 citations