The Influence of Alcohol-Induced Cerebellar Atrophy on Respiratory Rhythms at Rest

By Mirosevic, Monika; Kardum, Goran | Alcoholism, May 1, 2009 | Go to article overview

The Influence of Alcohol-Induced Cerebellar Atrophy on Respiratory Rhythms at Rest


Mirosevic, Monika, Kardum, Goran, Alcoholism


INTRODUCTION

Breathing is a function essential to life and is under control of numerous anatomic structures of the central nervous system.1

Since 1991, when Pre-Bòtzinger complex was first mentioned as an area in the brain stem whose role is to generate the basic rhythm of breathing in mammals, until today there have been numerous researches trying to find out how and why we breath.2 Recent studies show the involvement of cerebellum i.e. its deep nuclei, especially nucleus fastigii in the regulation of breathing.3 Past researches on the influence of cerebellum to the respiratory function were mostly done on animals and the data on similar studies on humans are scarce. So, research is necessary in order to make clear in what way cerebellum damage contributes to the pathophysiology of numerous conditions (obstructive apnea, Congenital Central Hyperventilation Syndrome, hyperpnea when required to meet demand), as well as to increase their understanding and improve therapeutic possibilities. One way of studying neural control of breathing in humans is to research cerebellum damage in alcoholics since cerebellar degeneration, which typically occurs after ten or more years of excessive alcohol intake,6 is frequent in their case.4·5 The assumption is that neuronal dysfunction which in alcohol addicts is caused by cerebellar degeneration will change eupneic breathing.

SUBJECTS AND METHODS

Subjects

The subjects were 1 1 alcohol addicts from the Club of Treated Alcoholics »Split« aged between 38 and 64. The criteria of inclusion into the research were the diagnosis of alcohol dependence and signs of cerebellar degeneration on magnet resonance (MRI).

A psychiatrist made the diagnosis of alcohol dependence according to the International classification of Diseases (ICD-IO, the tenth revision). All the subjects were male, smokers, abstinent from alcohol more than five months. The control group consisted of healthy men (N=Il) whose mean age corresponded to the mean age of the subjects alcoholics and who did not have problems with excessive drinking of alcoholic beverages.

Each subject filled in a form of voluntary acceptance of taking part into the research including the informed consent to diagnostic procedures of spirometry and magnet resonance.

The anamnesis and data on the period and quantity of alcoholic drinks the subjects had consumed were obtained by interview done before the inclusion in the research. The subjects were informed on the terms and procedures that were going to be performed during the examination. Neurologic status consisted of finger-nose testing, finger-nose-finger testing of the exarniner, »rebound« phenomenon for upper limbs and heel-knee and heel-knee-finger test for the coordination of lower limbs movements. Balance tests included Romberg's test with open and closed eyes, tandem walking (the subjects walk along a straight line placing one foot in front of the other touching the toes ofthe previous foot with the heel) and doing the walk-and-turn test.7

Radiologic diagnosis of cerebellar degeneration was based on signs of hemispheric atrophy and vermis atrophy on MRI.

Environmental conditions

The laboratory of clinical physiology of the School of Medicine, University of Split, Croatia, is based at the level of sea. All the tests were conducted in the afternoon. The temperature of the room was between 22 °C and 24°C.

Ventilation measurements

Ventilation measurements were done by the computerized spirometrie device Quark b2, Cosmed, Italy. The parameters were continuously collected according to the system of breath-by-breath with a facemask. Volumes and flows were measured by a flowmeter with bidirectional digital turbine 28 mm in diameter placed inside an optoelectronic reader. Turbine rotation caused by air flow interrupts the infrared light in the optoelectronic reader. The speed and direction of the turbine rotation are directly proportional to the speed and direction ofthe air flow. …

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