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Zhong Z, Li Q, Zou X, Ouyang Q, Zhang L, Liu X, Luo Y, Yao D. Effects of the low Fowler's sleep position and methazolamide treatment on sleep bruxism: A randomized controlled trial. J Sleep Res 2024:e14250. [PMID: 38803083 DOI: 10.1111/jsr.14250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/29/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
Intracranial pressure is one of the determinants of sympathetic activities, and sleep bruxism is associated with increased sympathetic activities. This study aimed to investigate effects of the low Fowler's sleep position and methazolamide treatment on the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes in patients with sleep bruxism in a randomized controlled trial. Polysomnographic recordings were performed on the patients with sleep bruxism sleeping in the low Fowler's (15°-30°) or supine position (n = 11), and with methazolamide or placebo treatment (100 mg, 3-4 hr before bedtime, P.O., n = 9), and changes in sleep variables and heart rate variance during sleep in the low Fowler's position or with methazolamide treatment were determined. Sleep bruxism index, number of masseter muscle electromyographic bursts per hour of sleep, ratio of rhythmic masticatory muscle activities/sleep bruxism duration to the total sleep duration, index of total limb movements, index of limb movements with rhythmic masticatory muscle activities, and number of sleep bruxism clusters per hour of sleep in the low Fowler's position and after methazolamide intake were significantly smaller (p < 0.05-0.001) than those in the supine position and after placebo intake, respectively. The low-frequency heart rate variance powers during non-rapid eye movement sleep stage 2 (N2) in the low Fowler's position and with methazolamide treatment were significantly lower (p < 0.05) than those during sleep in the supine position and with placebo treatment, respectively. In conclusion, sleep in the low Fowler's position and methazolamide treatment were associated with significant decreases in the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes, which might be due to a reduction in intracranial pressure and sympathetic activities mainly during non-rapid eye movement sleep stage 2.
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Affiliation(s)
- Zhijun Zhong
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Qi Li
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Qian Ouyang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Ling Zhang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Xinting Liu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Yaxing Luo
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
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Liu B, Yuan M, Yang M, Zhu H, Zhang W. The Effect of High-Altitude Hypoxia on Neuropsychiatric Functions. High Alt Med Biol 2024; 25:26-41. [PMID: 37815821 DOI: 10.1089/ham.2022.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023] Open
Abstract
Liu, Bo, Minlan Yuan, Mei Yang, Hongru Zhu, and Wei Zhang. The effect of high-altitude hypoxia on neuropsychiatric functions. High Alt Med Biol. 25:26-41, 2024. Background: In recent years, there has been a growing popularity in engaging in activities at high altitudes, such as hiking and work. However, these high-altitude environments pose risks of hypoxia, which can lead to various acute or chronic cerebral diseases. These conditions include common neurological diseases such as acute mountain sickness (AMS), high-altitude cerebral edema, and altitude-related cerebrovascular diseases, as well as psychiatric disorders such as anxiety, depression, and psychosis. However, reviews of altitude-related neuropsychiatric conditions and their potential mechanisms are rare. Methods: We conducted searches on PubMed and Google Scholar, exploring existing literature encompassing preclinical and clinical studies. Our aim was to summarize the prevalent neuropsychiatric diseases induced by altitude hypoxia, the potential pathophysiological mechanisms, as well as the available pharmacological and nonpharmacological strategies for prevention and intervention. Results: The development of altitude-related cerebral diseases may arise from various pathogenic processes, including neurovascular alterations associated with hypoxia, cytotoxic responses, activation of reactive oxygen species, and dysregulation of the expression of hypoxia inducible factor-1 and nuclear factor erythroid 2-related factor 2. Furthermore, the interplay between hypoxia-induced neurological and psychiatric changes is believed to play a role in the progression of brain damage. Conclusions: While there is some evidence pointing to pathophysiological changes in hypoxia-induced brain damage, the precise mechanisms responsible for neuropsychiatric alterations remain elusive. Currently, the range of prevention and intervention strategies available is primarily focused on addressing AMS, with a preference for prevention rather than treatment.
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Affiliation(s)
- Bo Liu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
- Zigong Mental Health Center, Zigong, China
| | - Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Mei Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China School of Basic Medical Sciences and Forensic Medicine, Chengdu, Sichuan
| | - Hongru Zhu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
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Gonye EC, Bayliss DA. Criteria for central respiratory chemoreceptors: experimental evidence supporting current candidate cell groups. Front Physiol 2023; 14:1241662. [PMID: 37719465 PMCID: PMC10502317 DOI: 10.3389/fphys.2023.1241662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
An interoceptive homeostatic system monitors levels of CO2/H+ and provides a proportionate drive to respiratory control networks that adjust lung ventilation to maintain physiologically appropriate levels of CO2 and rapidly regulate tissue acid-base balance. It has long been suspected that the sensory cells responsible for the major CNS contribution to this so-called respiratory CO2/H+ chemoreception are located in the brainstem-but there is still substantial debate in the field as to which specific cells subserve the sensory function. Indeed, at the present time, several cell types have been championed as potential respiratory chemoreceptors, including neurons and astrocytes. In this review, we advance a set of criteria that are necessary and sufficient for definitive acceptance of any cell type as a respiratory chemoreceptor. We examine the extant evidence supporting consideration of the different putative chemoreceptor candidate cell types in the context of these criteria and also note for each where the criteria have not yet been fulfilled. By enumerating these specific criteria we hope to provide a useful heuristic that can be employed both to evaluate the various existing respiratory chemoreceptor candidates, and also to focus effort on specific experimental tests that can satisfy the remaining requirements for definitive acceptance.
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Affiliation(s)
- Elizabeth C. Gonye
- Department of Pharmacology, University of Virginia, Charlottesville, VA, United States
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Doherty CJ, Chang JC, Thompson BP, Swenson ER, Foster GE, Dominelli PB. The Impact of Acetazolamide and Methazolamide on Exercise Performance in Normoxia and Hypoxia. High Alt Med Biol 2023; 24:7-18. [PMID: 36802203 DOI: 10.1089/ham.2022.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Doherty, Connor J., Jou-Chung Chang, Benjamin P. Thompson, Erik R. Swenson, Glen E. Foster, and Paolo B. Dominelli. The impact of acetazolamide and methazolamide on exercise performance in normoxia and hypoxia. High Alt Med Biol. 24:7-18, 2023.-Carbonic anhydrase (CA) inhibitors are commonly prescribed for acute mountain sickness (AMS). In this review, we sought to examine how two CA inhibitors, acetazolamide (AZ) and methazolamide (MZ), affect exercise performance in normoxia and hypoxia. First, we briefly describe the role of CA inhibition in facilitating the increase in ventilation and arterial oxygenation in preventing and treating AMS. Next, we detail how AZ affects exercise performance in normoxia and hypoxia and this is followed by a discussion on MZ. We emphasize that the overarching focus of the review is how the two drugs potentially affect exercise performance, rather than their ability to prevent/treat AMS per se, their interrelationship will be discussed. Overall, we suggest that AZ hinders exercise performance in normoxia, but may be beneficial in hypoxia. Based upon head-to-head studies of AZ and MZ in humans on diaphragmatic and locomotor strength in normoxia, MZ may be a better CA inhibitor when exercise performance is crucial at high altitude.
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Affiliation(s)
- Connor J Doherty
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Jou-Chung Chang
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Benjamin P Thompson
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Erik R Swenson
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Washington, USA
- Medical Service, VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Glen E Foster
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Paolo B Dominelli
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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Abstract
Despite extensive research, there is currently no approved drug for obstructive sleep apnea (OSA) treatment. OSA is a heterogeneous condition that involves multiple dominating pathophysiological traits. Drug development in this field needs to address both pathophysiological mechanisms and associated comorbid conditions in order to meet requirements for long-term therapy in OSA. Several drug candidates have been proposed and ongoing phase II trials that target various forms of sleep-disordered breathing have been initiated. The field is moving toward tailored therapeutic approaches in patients with OSA.
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Subudhi AW, Evero O, Reitinger J, Davis C, Gronewold J, Nichols AJ, Van‐Houten SJ, Roach RC. Combined methazolamide and theophylline improves oxygen saturation but not exercise performance or altitude illness in acute hypobaric hypoxia. Exp Physiol 2020; 106:117-125. [DOI: 10.1113/ep088461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/29/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Andrew W. Subudhi
- Altitude Research Center University of Colorado Anschutz Medical Campus Aurora CO USA
- Department of Human Physiology and Nutrition University of Colorado Colorado Springs Colorado Springs CO USA
| | - Oghenero Evero
- Altitude Research Center University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Jeremy Reitinger
- Altitude Research Center University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Christopher Davis
- Altitude Research Center University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Jeffrey Gronewold
- Altitude Research Center University of Colorado Anschutz Medical Campus Aurora CO USA
| | - Andrew J. Nichols
- Altitude Research Center University of Colorado Anschutz Medical Campus Aurora CO USA
| | | | - Robert C. Roach
- Altitude Research Center University of Colorado Anschutz Medical Campus Aurora CO USA
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Leacy JK, Day TA, O'Halloran KD. Carbonic anhydrase inhibition and chemoreflex control of breathing: A litmus test for methazolamide as a viable alternative to acetazolamide. Exp Physiol 2020; 105:230-231. [DOI: 10.1113/ep088238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 11/08/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Jack K. Leacy
- Department of PhysiologySchool of MedicineCollege of Medicine & HealthUniversity College Cork Cork Ireland
| | - Trevor A. Day
- Department of BiologyMount Royal University Calgary Alberta Canada
| | - Ken D. O'Halloran
- Department of PhysiologySchool of MedicineCollege of Medicine & HealthUniversity College Cork Cork Ireland
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Dominelli PB, Baker SE, Wiggins CC, Stewart GM, Sajgalik P, Shepherd JRA, Roberts SK, Roy TK, Curry TB, Hoyer JD, Oliveira JL, Foster GE, Joyner MJ. Dissociating the effects of oxygen pressure and content on the control of breathing and acute hypoxic response. J Appl Physiol (1985) 2019; 127:1622-1631. [PMID: 31647724 PMCID: PMC6962610 DOI: 10.1152/japplphysiol.00569.2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 11/22/2022] Open
Abstract
Arterial oxygen tension and oxyhemoglobin saturation (S a O 2 ) decrease in parallel during hypoxia. Distinguishing between changes in oxygen tension and oxygen content as the relevant physiological stimulus for cardiorespiratory alterations remains challenging. To overcome this, we recruited nine individuals with hemoglobinopathy manifesting as high-affinity hemoglobin [HAH; partial pressure at 50% S a O 2 (P50) = 16 ± 0.4 mmHg] causing greater S a O 2 at a given oxygen partial pressure compared with control subjects (n = 12, P50 = 26 ± 0.4 mmHg). We assessed ventilatory and cardiovascular responses to acute isocapnic hypoxia, iso-oxic hypercapnia, and 20 min of isocapnic hypoxia (arterial Po2 = 50 mmHg). Blood gas alterations were achieved with dynamic end-tidal forcing. When expressed as a function of the logarithm of oxygen partial pressure, ventilatory sensitivity to hypoxia was not different between groups. However, there was a significant difference when expressed as a function of S a O 2 . Conversely, the rise in heart rate was blunted in HAH subjects when expressed as a function of partial pressure but similar when expressed as a function of S a O 2 . Ventilatory sensitivity to hypercapnia was not different between groups. During sustained isocapnic hypoxia, the rise in minute ventilation was similar between groups; however, heart rate was significantly greater in the controls during 3 to 9 min of exposure. Our results support the notion that oxygen tension, not content, alters cellular Po2 in the chemosensors and drives the hypoxic ventilatory response. Our study suggests that in addition to oxygen partial pressure, oxygen content may also influence the heart rate response to hypoxia.NEW & NOTEWORTHY We dissociated the effects of oxygen content and pressure of cardiorespiratory regulation studying individuals with high-affinity hemoglobin (HAH). During hypoxia, the ventilatory response, expressed as a function of oxygen tension, was similar between HAH variants and controls; however, the rise in heart rate was blunted in the variants. Our work supports the notion that the hypoxic ventilatory response is regulated by oxygen tension, whereas cardiovascular regulation may be influenced by arterial oxygen content and tension.
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Affiliation(s)
- Paolo B Dominelli
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sarah E Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Glenn M Stewart
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - Pavol Sajgalik
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - John R A Shepherd
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Shelly K Roberts
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tuhin K Roy
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Timothy B Curry
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - James D Hoyer
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Jennifer L Oliveira
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Glen E Foster
- School of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, Canada
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
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