Tag: respiratory failure

Categories : NeurologyTags :

Discovery Offers Hope for Breathing Recovery After Spinal Cord Injuries

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Innovative research paves way for more effective treatment for ALS and other neurodegenerative diseases

View of the spinal cord. Credit: Scientific Animations CC4.0

Respiratory complications are the most common cause of illness and death for the 300 000 Americans living with spinal cord injury, according to the Christopher & Dana Reeve Foundation.  

But the results of a new study, led by researchers at Case Western Reserve University’s School of Medicine, show promise that a group of nerve cells in the brain and spinal cord, called interneurons, can boost breathing when the body faces certain physiological challenges, such as exercise and environmental conditions associated with altitude.

The researchers believe their discovery could lead to therapeutic treatments for patients with spinal cord injuries who struggle to breathe on their own. Their findings were recently published in the journal Cell Reports.

“While we know the brainstem sets the rhythm for breathing,” said Polyxeni Philippidou, an associate professor in the Department of Neurosciences at Case Western Reserve University School of Medicine and lead researcher, “the exact pathways that increase respiratory motor neuron output, have been unclear – until now.”

The research team included collaborators from the University of St. Andrews in the United Kingdom, the University of Calgary in Canada and the Biomedical Research Foundation Academy of Athens in Greece.

The study

By identifying a subset of interneurons as a new and potentially easy-to-reach point for treatment in spinal cord injuries and breathing-related diseases, the researchers believe doctors may be able to develop therapies to help improve breathing in people with such conditions.

The study showed that blocking signals from these spinal cord cells made it harder for the body to breathe properly when there was too much CO2 in the blood, a condition known as hypercapnia.

“These spinal cord cells are important for helping the body adjust its breathing in response to changes like high CO2 levels,” Philippidou said.

In this study, the team used genetically modified mouse models to explore the pathways involved in breathing. The researchers mapped neuron connections, measured neuron electrical activity, observed the models’ behaviour and used microscopy to visualise neuron structure and function – all focused on spinal cord nerve cells involved in breathing.

“We were able to define the genetic identity, activity patterns and role of a specialized subset of spinal cord neurons involved in controlling breathing,” Philippidou said.

The team is now testing whether targeting these neurons in neurodegenerative diseases like amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, and Alzheimer’s disease can help restore breathing.

Source: Case Western Reserve University

Categories : Medical Research & Technology Substance UseTags :

Opioid Respiratory Depression Reversed with Electrical Pulses

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Source: Pixabay CC0

Opioid use is a significant cause of premature death, caused by supressing respiratory activity. New research, published in The Journal of Physiology, points to a novel treatment for respiratory depression associated with opioid use that administers electrical pulses to the back of the neck, helping patients regain respiratory control following high dosage opioid use.

Breathing problems can occur after opioid use or post-operative complications from anaesthesia because opioids desensitise the brain stem to rises in carbon dioxide. This can cause respiratory failure, which can be fatal. Current treatments, such as manual lung inflation and medication, can work in the short term to combat breathing problems following opioid use, but getting patients to breathe independently remains a challenge. Therefore, this new research, which administers epidural electrical stimulation (EES) offers an alternative, non-pharmacological treatment.

EES administered at the cervical spinal cord, which is located at the back of the neck, activates a network of neurons in the brainstem that stimulates and coordinates respiratory muscles and improves the rate and depth of breathing.

Researchers from the University of California, Los Angeles (UCLA), targeted sensory-motor circuits in the cervical spinal cord of 18 patients with degenerative spine diseases who were anaesthetised for surgical treatment. They delivered 30 Hertz of EES to the cervical spinal cord continuously for no longer than 90 seconds.

They found that short periods of continuous low-intensity EES not only increased the volume of breath but also actively controlled the frequency and rhythm during opioid-induced breathing problems. The rhythmic breathing pattern was sustained briefly after the EES stopped in the presence of high-dose opioids.

Senior author Dr Daniel Lu, UCLA professor and vice chair of neurosurgery, said: “Our results provide proof of principle that cervical EES could improve respiration following opioid use. We can compare the human body to a car, our goal is to jump start the body so it can run by itself without periodic pushes. We hope to use EES to provide novel approaches to restore breathing for healthcare providers as we are now using defibrillation devices for restoring cardiac activities.”

Future human trials with larger cohorts will be conducted to further assess the practical application and impact of EES to determine whether EES can alleviate or reduce the need for ventilator support in acute pathological conditions such as OIRD, stroke, and traumatic brain, brain stem or spinal cord injury. Experimental studies in mice will be carried out to further investigate the role specific neurons play in response to EES.

Source: Physiological Society