努力中の脳 : 呼吸器疾患患者における低酸素症の影響 (NEUROX)
脳の酸素化は、CaO2 と脳血流 (CBF) の積によって決定されます。どちらか一方を変更すると、ニューロンの O2 利用可能性に影響を与える可能性があります。
PaO2 の効果に加えて、CBF は PaCO2 によっても調節されます。 低酸素状態での努力中、PaCO2 の潜在的な減少に関連する PaO2 の低下、したがって CBF の低下は、脳の O2 の需要と供給の間に重要なめまいを引き起こす可能性があります。
ちょうど運動皮質の生成が運動指令を生成するように、低酸素症は中枢神経細胞の反応に重大な問題を引き起こす可能性があるようです.
研究によると、重度の低酸素状態での運動は、脳の酸素化と運動指令にとって必要な脅威となり、結果として運動能力が低下することが示唆されています。
このプロジェクトは、慢性呼吸器疾患に苦しむ患者の脳機能に対する低酸素症の影響を研究することを目的としています。 血液中のガスの異常を修正するための治療前後の低酸素被験者に生じる点滴および脳酸素化、皮質興奮および運動指令を含む、休息中または運動中の脳の神経生理学的反応。
この研究では、学際的で補足的な方法論的アプローチを使用します。点滴と脳の酸素化を評価するための近赤外分光法(NIRS)、CBF、神経刺激手順、および皮質興奮性を評価するための筋電図検査(EMG)、中枢活性化と運動のレベルの測定指図。
この研究の目標は次のとおりです。
- 点滴と脳の酸素化、大脳皮質の興奮性、随意活性化のメカニズム、および健康な対照被験者と比較した慢性低酸素症患者の努力に対する中枢性疲労を測定します。
- さまざまなレベルの脳タスクを含む、単純なタスクと二重のタスクで、移動パラメーターと姿勢造影の混乱を分析します。
- 慢性閉塞性肺疾患 (COPD) に苦しむ患者の動脈酸素化の改善が、点滴および脳の酸素化、皮質興奮性、随意活性化および中枢性疲労のメカニズムに及ぼす急性効果を分析します。
- 同じパラメーターを使用して、閉塞性睡眠時無呼吸 (OSA) に苦しむ患者に対する持続気道陽圧 (CPAP) による治療の効果を評価します。
調査の概要
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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-
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La Tronche、フランス、38700
- UniversityHospitalGrenoble
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
包含基準:
COPD患者
- ステージ GOLD III - IV、FEV1/FVC 比 < 0.7 および最大自発換気量 (MVV) < 予測値の 50%
- BMI < 30 kg/m²
- 18歳から80歳までの年齢
- 非喫煙者または元喫煙者 (3 か月以上禁煙)
- 3ヶ月以上安定した状態
- PaCO2 < 45 mmHg 外気で安静
- OSA 診断なし
OSA患者
- 最近診断された重度のOSA(無呼吸低呼吸指数(AHI)> 30)
- エプワース眠気尺度 (ESS) > 10 のスコア
- 18歳から80歳までの年齢
- BMI < 30 kg/m²
対照群
- 18歳から80歳までの年齢
- BMI < 30 kg/m²
- 非喫煙者
- 慢性呼吸器疾患、心血管、代謝、腎臓または神経筋、前庭および/または視覚障害がない
除外基準:
OSAおよびCOPD患者
- 病態 心血管、神経筋、代謝、腎臓
- アルコール依存症
- BMI > 30 kg/m²
- 精神障害または行動障害の病歴、視覚障害、前庭障害、姿勢制御および歩行を混乱させる神経疾患、認知障害
- 3ヶ月未満から不安定
- 外部磁場の適用に対する反論
対照群
- 呼吸器疾患、心血管、神経筋、代謝、腎臓
- アルコール依存症
- BMI > 30 kg/m²
- 精神障害または行動障害の病歴
- 外部磁場の適用に対する反論
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:BASIC_SCIENCE
- 割り当て:ランダム化
- 介入モデル:平行
- マスキング:なし
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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ACTIVE_COMPARATOR:慢性閉塞性肺疾患(COPD)
18人の患者
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最大有酸素パワーの 80% で、疲労するまで
枯渇するまで
|
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ACTIVE_COMPARATOR:睡眠時無呼吸症候群(OSA)
18人の患者
|
最大有酸素パワーの 80% で、疲労するまで
枯渇するまで
|
|
ACTIVE_COMPARATOR:健康ボランティア
36人の対照患者
|
最大有酸素パワーの 80% で、疲労するまで
枯渇するまで
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
近赤外分光法(NIRS)
時間枠:30分
|
O2 と CO2 のさまざまな割合の吸入に反応して、安静時または努力中の筋肉および大脳レベルでの総デオキシヘモグロビンおよびヘモグロビンの量。
|
30分
|
協力者と研究者
捜査官
- 主任研究者:Patrick Levy, Professor、Grenoble Hospital University
出版物と役立つリンク
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