Activation of the human diaphragm from the motor cortex.

Gandevia, Simon C.; Rothwell, John C.

doi:10.1113/jphysiol.1987.sp016445

Cited by 220 publications

(143 citation statements)

References 23 publications

Supporting

Mentioning

126

Contrasting

Order By: Relevance

“…However, the mean value of Cx-MEP latency of our patients was slightly longer with respect to controls. Our Cx-MEP latency values from Dia are comparable with those reported by Gandevia and Rothwell (1987) and Zifko et al (1996), although 1.5 ms longer than those reported by Khedr and Trakhan (2001). Such a discrepancy can be due to methodological differences with regard to the site of cortical stimulation and of the recording electrodes.…”

Section: Discussionsupporting

confidence: 71%

See 1 more Smart Citation

Are the neurophysiological techniques useful for the diagnosis of diaphragmatic impairment in multiple sclerosis (MS)?

Miscio

Guastamacchia

Priano

et al. 2003

Clinical Neurophysiology

View full text Add to dashboard Cite

Objective: To characterize cortico-diaphragmatic pathway involvement in multiple sclerosis (MS) by means of transcranial magnetic stimulation (TMS), and verify its clinical impact.Methods: TMS from diaphragm (Dia), and abductor digiti minimi (AbdV8) was performed in 26 MS patients. Phrenic nerve (PN) conduction study was also performed. Expanded disability status scale (EDSS) and fatigue descriptive scale (FDS) were measured. Forced vital capacity (FVC), forced expiratory volume at the first second (FEV1), peak expiratory flow (PEF) were tested: the predicted percentage value (% pred) was considered.Results: Cortical motor evoked potential (Cx-MEP) latency and central motor conduction time (CMCT) were prolonged, respectively, in 31 and 23% of patients from Dia, in 76 and 79% from AbdV8. PN-compound motor action potential (CMAP) was normal. EDSS correlated to Cx-MEP from AbdV8 (P , 0:01), and PN-CMAP amplitude (P , 0:05), FEV1 % pred (P , 0:01), PEF % pred (P , 0:01). PN-CMAP amplitude correlated to FVC % pred P ¼ 0:05, FEV1 % pred P , 0:01, PEF % pred P , 0:01. Fatigue was related to AbdV8 Cx-MEP and CMCT (P , 0:05 and P , 0:01).Conclusions: Cortico-diaphragmatic pathway is impaired only in a minority of MS patients. Lack of correlation between TMS findings from Dia and respiratory tests argues against its routinary use to detect subclinical respiratory alterations. Fatigue seems to be related to the motor impairment rather than to respiratory distress. q

show abstract

Section: Discussionsupporting

confidence: 71%

“…The study by Corfield et al (1998) demonstrated that motor cortical excitation of the diaphragm is not mediated via brainstem respiratory neurons but, most likely, via the more direct corticospinal tract, fast conducting and oligosynaptic (Gandevia and Rothwell, 1987).…”

Section: Discussionmentioning

confidence: 99%

Are the neurophysiological techniques useful for the diagnosis of diaphragmatic impairment in multiple sclerosis (MS)?

Miscio

Guastamacchia

Priano

et al. 2003

Clinical Neurophysiology

View full text Add to dashboard Cite

show abstract

“…Cortical representation of the diaphragm within the primary motor cortex was first detected using cortical electrical stimulation by Foerster in 1936 [24]. It was also localised using transcranial electrical and magnetic stimulation [25,26]. It is situated within the primary motor cortex between the arm and leg representations.…”

Section: The Cortical and Subcortical Respiratory Networkmentioning

confidence: 99%

Imaging the brain during sniffing: A pilot fMRI study

Koritnik¹,

Azam²,

Andrew³

et al. 2009

Pulmonary Pharmacology & Therapeutics

View full text Add to dashboard Cite

Whilst the act of sniffing can provide us with an indirect method to study the central mechanisms of respiratory control, functional neuroimaging now provides us with a tool to directly visualise the activity of the human brain during this voluntary action using functional magnetic resonance imaging (fMRI).We performed fMRI during sniffing in 11 healthy volunteers where all subjects executed single, brisk sniffs of around 60% of their maximum sniff pressure at intervals of approximately every 20 s. Simultaneous nasal pressure and chest movements were also measured during the task and a statistical parametric map of activation correlating with the sniff manoeuvre was calculated.A bilateral cortical and subcortical sensorimotor network was activated. The activations were localised within the primary sensorimotor cortex, lateral premotor cortex, supplementary motor area, anterior cingulate, insula, basal ganglia, thalami, mesencephalon, upper pons, cerebellar vermis, piriform cortex, entorhinal cortex and parahippocampal gyrus.The activated brain areas identified, i.e. the cortical and subcortical respiratory network, are similar to those described in other neuroimaging studies of voluntary inspiration. Sniffing is a component of olfactory processing and activations of the olfaction-related cortical areas were also observed in our study.The results of our study show that event-related fMRI can be successfully used to study sniffing. This provides a novel approach to our study of the central neural control of respiration.

show abstract

“…Such studies suggest that the insula and operculum mediate dyspnea (Banzett et al, 2000;Evans et al, 2002;McKay et al, 2008;Peiffer, 2008;Peiffer et al, 2008;von Leupoldt et al, 2008), and the cingulate gyrus, the prefrontal cortex, and the supramarginal gyrus integrate emotional and sensory aspects of respiration. The motor cortex is implicated in the volitional control of breathing and speech (Gandevia and Rothwell, 1987;McKay et al, 2003;Brown et al, 2008). It is plausible that brain regions that express both high densities of opioid receptors and modulate respiration (particularly the insula, operculum, and prefrontal cortex) (Baumgärtner et al, 2006;Tracey and Mantyh, 2007) are likely to have a role in mediating opioid-induced respiratory depression.…”

Section: Introductionmentioning

confidence: 99%

Opioids Depress Cortical Centers Responsible for the Volitional Control of Respiration

Pattinson¹,

Governo²,

MacIntosh³

et al. 2009

Journal of Neuroscience

152

138

View full text Add to dashboard Cite

Respiratory depression limits provision of safe opioid analgesia and is the main cause of death in drug addicts. Although opioids are known to inhibit brainstem respiratory activity, their effects on cortical areas that mediate respiration are less well understood. Here, functional magnetic resonance imaging was used to examine how brainstem and cortical activity related to a short breath hold is modulated by the opioid remifentanil. We hypothesized that remifentanil would differentially depress brain areas that mediate sensoryaffective components of respiration over those that mediate volitional motor control. Quantitative measures of cerebral blood flow were used to control for hypercapnia-induced changes in blood oxygen level-dependent (BOLD) signal. Awareness of respiration, reflected by an urge-to-breathe score, was profoundly reduced with remifentanil. Urge to breathe was associated with activity in the bilateral insula, frontal operculum, and secondary somatosensory cortex. Localized remifentanil-induced decreases in breath hold-related activity were observed in the left anterior insula and operculum. We also observed remifentanil-induced decreases in the BOLD response to breath holding in the left dorsolateral prefrontal cortex, anterior cingulate, the cerebellum, and periaqueductal gray, brain areas that mediate task performance. Activity in areas mediating motor control (putamen, motor cortex) and sensory-motor integration (supramarginal gyrus) were unaffected by remifentanil. Breath hold-related activity was observed in the medulla. These findings highlight the importance of higher cortical centers in providing contextual awareness of respiration that leads to appropriate modulation of respiratory control. Opioids have profound effects on the cortical centers that control breathing, which potentiates their actions in the brainstem.

show abstract

Activation of the human diaphragm from the motor cortex.

Cited by 220 publications

References 23 publications

Are the neurophysiological techniques useful for the diagnosis of diaphragmatic impairment in multiple sclerosis (MS)?

Are the neurophysiological techniques useful for the diagnosis of diaphragmatic impairment in multiple sclerosis (MS)?

Imaging the brain during sniffing: A pilot fMRI study

Opioids Depress Cortical Centers Responsible for the Volitional Control of Respiration

Contact Info

Product

Resources

About