Dr. John Bach (left), Professor of Physical Medicine and Rehabilitation and Professor of Neurosciences at UMDNJ-New Jersey Medical School, is currently conducting a FightSMA funded study entitled “Autonomic Dysfunction in Childhood Onset Spinal Muscular Atrophy.” While autonomic dysfunction in spinal muscular atrophy (SMA) patients has been recognized in clinical practice, it has not been officially studied or reported in literature. Dr. Bach and FightSMA hope to expand the understanding of the relationship between SMA and autonomic dysfunction with this study.

According to Dr. Bach, “about 20% of children with SMA type 1 and 2 have slowing of heart rate below 60 beats per minute. At times the slowing is to below 40 beats per minute and results in loss of consciousness.” Dr. Bach goes on to explain that in some cases children have died suddenly because their heart rates dropped to zero. Heart rate is largely controlled by the “autonomic nervous system” (ANS) which is divided into two systems, the sympathetic and the parasympathetic. The sympathetic part causes the heart to speed up and the parasympathetic causes the heart to slow down. An imbalance between the two parts can result in a heart arrhythmia (a disturbance in the rhythm of the heartbeat) and can cause the heart to stop. Dr. Bach explains:

“Slowing, what we call “bradycardias”, can be a reaction to the heart “racing”, a “tachycardia”. Thus, anything that causes the heart rate to speed up like a fever, mucus plug, or excitement, that is, sympathetic stimulation, might result in a reactive bradycardia. Bradycardias can also occur without a tachycardia. In this case it would be from too little sympathetic activity to counter balance parasympathetic stimulation…The purpose of our study is to determine the sympathetic-parasympathetic balance of the innervations of the heart to help us figure this out.”

Using noninvasive equipment to record heart rate variability and respirations, the study compares the ANS activity of 100 SMA patients to the ANS of 100 control subjects of matching age and gender. Analysis of the data gathered may help identify autonomic dysfunction and determine treatment strategies. Dr. Bach continues to receive SMA patients for this study at his office in New Jersey.

For more information, please contact:
John R. Bach, MD
Physical Medicine and Rehabilitation
University of Medicine & Dentistry of New Jersey
90 Bergen Street, DOC 3100
Newark NJ 07103
Practice Phone: 973-972-2802
Email: bachjr@umdnj.edu
Website: www.doctorbach.com