October 02, 2014

Carrie Bebermeyer

New SLU Study Seeks to Help ALS Patients Breathe


SLU physicians Ghazala Hayat, M.D, Melanie Edwards, M.D., and Keith Naunheim, M.D.  


ST. LOUIS – As part of a multi-center clinical trial, Saint Louis University researchers will study whether a surgically implanted device can help patients with amyotrophic lateral sclerosis (ALS) slow muscle loss that leads to breathing difficulties. The device, the NeuRx Diaphragm Pacing System, electrically stimulates the diaphragm muscle, an approach researchers hope will preserve muscle fibers and prevent muscle loss.

Also known as “Lou Gehrig's Disease,” ALS is a degenerative motor neuron disease that affects nerve cells in the brain and spinal cord. People who have ALS experience debilitating side effects, including muscle weakness, difficulty speaking and trouble breathing and swallowing. Eventually, the illness leads to death.

As nerve cells die, muscle control is lost, including the chest muscles involved in breathing. Most sufferers eventually need mechanical ventilation in order to breathe. Respiratory failure is the most common cause of death in patients with ALS.

In this study, led at Saint Louis University by Ghazala Hayat, M.D., professor of neurology and director of neurophysiology and neuromuscular services, researchers will test the safety and efficacy of the surgically implanted diaphragm pacing system and compare it to the current standard of care, noninvasive ventilation.

“We need better options to treat patients with ALS,” says Hayat, who also is a SLUCare neurologist.

The diaphragm pacing system currently is used to improve diaphragm muscle function in patients with spinal cord injuries, allowing many to discontinue the use of mechanical ventilation. Researchers want to know if the same system will help ALS patients. Investigators believe it may work by preserving type I muscle fibers and preventing diaphragm deconditioning.

The 20 center sites will enroll patients with ALS and randomly assign them to receive the diaphragm pacing system or the current standard of care noninvasive ventilation, at a ratio of two to one.

SLUCare cardiothoracic surgeons, Keith Naunheim, M.D. and Melanie Edwards, M.D., will implant the device for those assigned to the diaphragm pacing system group.

“We are searching for ways to extend life expectancy for patients with ALS. With this study we hope to see if the diaphragm pacing system can accomplish this,” says Edwards, who also is assistant professor of surgery at SLU.

To learn more about the study, contact Saint Louis University researcher Ghazala Hayat, M.D., (314-977-4860) or study coordinator Craig Dedert, R.N., (314-577-8461).

Hayat is also director of Saint Louis University’s ALS clinic which is one of only 35 ALS Association certified centers in the country. The clinic develops treatment plans for patients in collaboration with more than a dozen caregivers, including neurologists, social workers, dietitians, physical, occupational, respiratory and speech therapists.

Read a St. Louis Post-Dispatch story about Hayat’s work in SLU’s ALS clinic.

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.

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