This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Over the past decade, the prevalence of childhood obesity has dramatically escalated, reaching epidemic proportion. Despite the fact that obstructive sleep apnea (OSA) is widely associated with cognitive deficits, metabolic, and cardiovascular sequelae, the underlying mechanistic basis for the disease in obese adolescents is unknown. Because of this, early identification and treatment of OSA in obese children remains unachievable. The proposed research will fill important gaps in our knowledge base and set the stage for future research on predisposing factors for OSA in obese children. Awareness of these factors will enable early intervention and ultimately result in reduced morbidity in this group of children. The primary objective of the candidate's research is to test the hypothesis that central adiposity is strongly associated with increased pharyngeal wall motion in obese adolescents. A second objective of this research is to determine the relationship between increased pharyngeal wall motion and OSA. The third objective is to study the effect of body composition change on pharyngeal wall motion in obese adolescents with OSA. Pharyngeal wall motion will be determined in awake subjects by change in coefficient of variation of pharyngeal volume, as measured by MR cine imaging, after topical pharyngeal anesthesia. The proposed research is innovative in that it utilizes a new approach to the study of airway dynamics, which is the non-invasive and precise method of volume segmentation of cine MR data. The simultaneous assessment of airway structure and dynamics by this method allows the assessment of pharyngeal dynamics independent of airway size.
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