Gate mechanism in breathlessness caused by chest wall vibration in humans

Homma, Ikuo; Obata, Toshihiko; Sibuya, Masato; Uchida, Masatsugu

doi:10.1152/jappl.1984.56.1.8

Cited by 58 publications

(35 citation statements)

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“…Since there is much evidence to suggest that afferent information from the lung and/or chest wall modifies the intensity of dyspnoea by inhibitory feed back [23][24][25][26], it is likely that the observed relief of dyspnoea during NPAV with the assist-control mode is partly due to stimulation of these receptors coinciding with inspiration. In this regard, it has been postulated that there may be a certain central gating mechanism that operates in relation to the sensation of dyspnoea [27]. In accordance with this postulation, sensation of dyspnoea may be alleviated when afferent information from the lung and/or chest wall matches the central operating phase.…”

Section: Discussionmentioning

confidence: 96%

Effects of negative pressure assisted ventilation on dyspnoeic sensation and breathing pattern

Nishino

Isono²,

Ide³

1998

Eur Respir J

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Although negative pressure assisted ventilation with an assist-control mode may have a potential therapeutic role in the treatment of severe dyspnoea, the effects of negative pressure assisted ventilation with the assist-control mode on dyspnoea and breathing patterns have not been examined. We examined the effects of negative pressure assisted ventilation with the assist-control mode on dyspnoea and breathing patterns produced by a combination of resistive loading and hypercapnia in nine healthy subjects breathing spontaneously. Subjects were asked to rate their sensation of respiratory discomfort using a visual analogue scale. Negative pressure assisted ventilation caused a significant reduction in sensation of respiratory discomfort from a visual analogue scale score of 74 (55-91) (median (range)) before negative pressure assisted ventilation to 34 (15-53) during negative pressure assisted ventilation (p<0.01). During negative pressure assisted ventilation, there were significant changes in breathing patterns characterized by an increase in tidal volume and a decrease in respiratory frequency, while neither minute ventilation nor end-tidal carbon dioxide tension changed. Our results indicate that negative pressure assisted ventilation with the assist-control mode is effective in relief of dyspnoea and that negative pressure assisted ventilation influences the control of breathing to minimize respiratory discomfort.

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Section: Discussionmentioning

confidence: 96%

Effects of negative pressure assisted ventilation on dyspnoeic sensation and breathing pattern

Nishino

Isono²,

Ide³

1998

Eur Respir J

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“…There is no direct evidence that the chest wall tightness commonly observed in subjects with IH is induced by the activation of muscle afferents or gamma motor activity. However, there is evidence to suggest that outof-phase vibration induces breathlessness in normal subjects [17] and in patients with COPD. On the contrary, in-phase vibration decreases dyspnea [18].…”

Section: Discussionmentioning

confidence: 99%

Breathing Patterns Associated with Trait Anxiety and Breathlessness in Humans

Masaoka

Jack

Warburton

et al. 2004

JJP

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During periods of increased anxiety there is an increase in respiratory frequency which correlates significantly with individual trait anxiety. These changes are observed especially in high trait individuals and occur with no change in V . co 2 or tidal volume, but with a resultant decrease in end tidal CO 2 (P ET CO 2 ).Recent work focusing on human brain activities has suggested that the temporal pole and the amygdala in the limbic system are activated during increased anxiety in high-trait individuals. The activation of these areas participates in the enhancement of respiratory frequency in normal subjects [6].Idiopathic hyperventilation (IH) is a condition of uncertain aetiology that is characterized by sustained arterial and alveolar hypocapnia and a plethora of It is generally agreed that a central pattern generator (CPG) for respiration exists in the lower brainstem; however, respiratory patterns in the awake state are also affected by the higher brain centers to varying degrees, dependent on the arousal level [1], the emotional state [2] and personality trait [3]. In the conscious state, carbon dioxide inhalation modifies the breathing pattern primarily by a stimulation of chemoreceptors. However, the final respiratory output results from a strong interaction between requirements from metabolism and behavior.It is well known that the emotions of fear and anxiety generated in the limbic system cause physiological changes in heart rate, perspiration and respiration [4]. Anxiety increases respiratory frequency and minute ventilation with no change in metabolism [5].Japanese Journal of Physiology Vol. 54, [465][466][467][468][469][470] 2004 Received on August 4, 2004; accepted on October 13, 2004 Correspondence should be addressed to: Ikuo Homma, Department of Physiology II, Showa University School of Medicine, 1-5-8 Hatanodai. Shinagawa-ku, Tokyo 142-8555, Japan. Phone: +81 3 3784 8113, Fax: +81 3 3784 0200, E-mail: ihomma@med.showa-u.ac.jp Abstract: Idiopathic hyperventilation (IH) is a condition of uncertain aetiology characterized by sustained arterial and alveolar hypocapnia and a plethora of symptoms, the most commonly reported being shortness of breath, and breathlessness. We previously reported that anxiety increases respiratory frequency and minute ventilation with no change in metabolism in normal subjects. In this study, we compared the breathing frequency response to 5% and 7% of CO 2 gas mixtures in normal subjects (n = 13) and in subjects with IH (n = 9), taking into account anxiety and breathlessness in order to determine how breathing patterns may vary with changes in the degree of involvement of higher brain centers because of anxiety and the perception of breathlessness. CO 2 produced a significantly higher value in respiratory frequency (f ) in subjects with IH. Subjects with IH also showed lower P ET CO 2 than normal subjects. During the inhalation of room air, a significant correlation between f and trait anxiety scores was observed in normal subjects (r = 0.49) and IH subjects (r = 0...

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“…The study protocol was approved by the Showa University Ethics Committee and informed consent was obtained from all participants. Details of chest wall vibration are described in our previous reports (4,6). Twoupper vibrators, attached bilaterally at the second or third intercostal spaces in the parasternal region, were vibrated during the inspiratory phase, and two lower vibrators, attached bilaterally on the anterior axillary lines at the seventh to ninth intercostal spaces, were vibrated during the expiratory phase.…”

Section: Methodsmentioning

confidence: 99%

“…In-phase vibration (IPV, vibration of the contracting intercostal muscle, namely the inspiratory intercostal muscle during the inspiratory phase and the expiratory intercostal muscle during the expiratory phase) decreases dyspnea induced in normal subjects (3) and in chronic obstructive pulmonary disease (COPD) patients at rest and during leg exercise (4,5). The alternate mode, ' outof-phase vibration' (vibration of the non-contracting intercostal muscle, namely the inspiratory intercostal muscle during the expiratory phase and the expiratory intercostal muscle during the inspiratory phase) increases dyspnea (4,6). The effect of IPV on dyspnea is hypothesized to involve stimulation of the muscle spindles, as IPV also increases tidal volume and decreases functional residual capacity, suggesting a tonic vibration reflex in the contracting intercostal muscles (4,7,8).…”

Section: Introductionmentioning

confidence: 99%

In-phase Chest Wall Vibration Decreases Dyspnea During Arm Elevation in Chronic Obstructive Pulmonary Disease Patients.

et al. 1998

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In-phase chest wall vibration (IPV) is knownto decrease dyspnea in patients with chronic obstructive pulmonary disease (COPD) at rest and during leg exercise. In the present study, the effects of IPV (100 Hz) on dyspnea and arm fatigue during upper extremity activity were studied in 9 patients with COPD(mean FEV1? 0.95 /). Dyspnea and arm fatigue (modified Borg scale) and ventilatory variables were measured during arm elevation (AE) with weights lifted straight above the head with and without IPV. Mean dyspnea during AE was 3.3 without IPV and 2.1 with IPV (p<0.05), but, arm fatigue, oxygen saturation and end-tidal Fco2 were not affected by IPV. Minute ventilation during AEwas significantly increased with IPV in 5 of 9 patients. The results suggest that IPV decreases dyspnea during AE.

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Gate mechanism in breathlessness caused by chest wall vibration in humans

Cited by 58 publications

References 0 publications

Effects of negative pressure assisted ventilation on dyspnoeic sensation and breathing pattern

Effects of negative pressure assisted ventilation on dyspnoeic sensation and breathing pattern

Breathing Patterns Associated with Trait Anxiety and Breathlessness in Humans

In-phase Chest Wall Vibration Decreases Dyspnea During Arm Elevation in Chronic Obstructive Pulmonary Disease Patients.

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