Four exemplary SMU researchers have been chosen as the University’s 2013 Ford Research Fellows. This year’s recipients are Michael Corris, Art, Meadows School of the Arts; Bonnie Jacobs, Earth Sciences, Dedman College of Humanities and Sciences; Suku Nair, Computer Science and Engineering, Lyle School of Engineering; and Thomas Ritz, Psychology, Dedman College of Humanities and Sciences.
Established in 2002 through a $1 million pledge from SMU Trustee Gerald J. Ford, the fellowships help the University retain and reward outstanding scholars. Each recipient receives a cash prize for research support during the year.
Panic attacks that seem to strike out of the blue are not without warning after all, says SMU psychologist Alicia Meuret.
In a rare study in which patients were monitored around the clock as they conducted their daily activities, portable recorders captured changes in respiration, heart rate and other bodily functions. The researchers discovered that waves of significant physiological instability occurred for at least 60 minutes before patients became aware of an impending panic attack, says Meuret, associate professor of psychology and lead researcher on the study.
The new findings suggest sufferers of panic attacks may be highly sensitive to – but unaware of – an accumulating pattern of subtle physiological instabilities that occur before an attack, Meuret said. (By definition, the majority of the 13 symptoms of panic attack are physiological: shortness of breath, heart racing, dizziness, chest pain, sweating, hot flashes, trembling, choking, nausea and numbness.) Monitoring data also showed patients were hyperventilating on a chronic basis.
“Most patients obviously feel that there must be something going on physically,” Meuret says. “They worry they’re having a heart attack, suffocating or going to pass out. Our data doesn’t indicate there’s something inherently wrong with them physically, neither when they are at rest nor during panic. The fluctuations that we discovered are not extreme; they are subtle. But they seem to build up and may result in a notion that something catastrophic is going on.”
Notably, the researchers found that patients’ carbon dioxide (C02) levels were in an abnormally low range, indicating the patients were chronically hyperventilating. These levels rose significantly shortly before panic onset and correlated with reports of anxiety, fear of dying and chest pain.
“It has been speculated, but never verified with data recordings in daily life, that increases in CO2 cause feelings of suffocation and can be panic triggers,” Meuret says.
Meuret and her colleagues discovered these patterns using change-point analysis, a statistical method that searches for points when changes occur in a “process” over time.
“This analysis allowed us to search through patients’ physiological data recorded in the hour before the onset of their panic attacks to determine if there were points at which the signals changed significantly,” says SMU Associate Professor of Psychology David Rosenfield, lead statistician on the project.
The study is significant not only for panic disorder, but also for other medical problems where symptoms and events have seemingly “out-of-the blue” onsets, such as seizures, strokes and even manic episodes.
In a multidisciplinary collaboration, other authors on the study were psychologist Thomas Ritz, SMU Department of Psychology; psychologist Frank H. Wilhelm, University of Salzburg, Austria; electrical engineer Enlu Zhou, University of Illinois at Urbana-Champaign; and psychologist Ansgar Conrad and psychiatrist Walton T. Roth, both of Stanford University.
As the health care reform debate turns to cutting costs and improving treatment outcomes, two SMU professors are expanding a study that shows promise for reducing both the expense and suffering associated with chronic asthma.
Thomas Ritz and Alicia Meuret, both of SMU’s Psychology Department, have developed a four-week program to teach asthmatics how to better control their condition by changing the way they breathe.
With the help of a four-year, $1.4 million grant from the National Institutes of Health, they plan to engage 120 Dallas County patients in four weeks of breathing training by the study’s projected end in July 2012. Their co-investigators include David Rosenfield, also of SMU’s Psychology Department, and Mark Millard, M.D., of Baylor University Medical Center.
During an attack, sufferers tend to hyperventilate, breathing fast and deep against constricted airways to fight an overwhelming feeling of oxygen deprivation.
Unfortunately, this makes the problem worse by lowering the body’s carbon dioxide levels, which restricts blood flow to the brain and can further irritate already hypersensitive bro nchial passages.
Patients who “overbreathe” on a sustained basis risk chronic CO2 deficiencies that make them even more vulnerable to future attacks. Rescue medications that relieve asthma symptoms do nothing to correct breathing difficulties associated with hyperventilation.
As part of SMU’s Stress, Anxiety and Chronic Disease Research Program, Ritz and Meuret use their biofeedback-based Capnometry-Assisted Respiratory Training (CART) to teach asthma patients to normalize and reverse chronic overbreathing. A hand-held device called a capnometer measures the amount of CO2 exhaled. Using this device, patients learn how to breathe more slowly, shallowly and regularly.
CART techniques could have a positive impact on quality of asthma treatment even as they reduce the need for acute care, Ritz says.
“The research shows that this kind of respiratory therapy can limit both the severity and frequency of asthma attacks,” he says. “That means fewer doctor visits and less frequent use of rescue medications, with the associated savings of both time and money.”
And for those who count any year without a trip to the emergency room as a year with a good treatment outcome, that means a higher quality of life, says Meuret, who lives with asthma herself.
“The training gives patients new ways to deal with acute symptoms, and that helps them to feel more in control,” she says.