Phrenic Nerve Conduction Abnormalities Correlate with Diaphragmatic Descent in Chronic Obstructive Pulmonary Disease

El-tantawi, G.; Imam, Mohamed Hassan; Morsi, Tamer S.

doi:10.3109/15412555.2014.993465

Cited by 18 publications

(11 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rate of detectable myosin decreases, resulting in altered sarcomeric organization and further decreasing of the contractile strength [6]. The phrenic activity is abnormal, presumably due to the nerve stretching caused by the chronic lowering of the diaphragm, resulting in such a neuropathy [7]. The exercise intolerance in patients with COPD does not correlate with the common functional index (forced expiratory volume in 1 second -FEV1); rather it is the peripheral muscle adaptation, including that of the diaphragm, to have a heavy influence on the symptomatic scenario [8,9] (Figures 1 and 2).…”

Section: Adaptation Of the Diaphragm In Patients Affected By Copdmentioning

confidence: 99%

Depression, anxiety and chronic pain in patients with chronic obstructive pulmonary disease: the influence of breath

Bordoni

Marelli²,

Bruno

et al. 2017

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is a major public health problems, causing significant mortality and morbidity in the world. It is a complex and progressive disease, characterized by chronic inflammation and dysfunction of the respiratory airways. The article reviews the available information on the potential role of the diaphragm in this disease. The purpose is to identify a potential correlation between symptoms such as depression, anxiety and chronic pain, frequently observed in COPD, with the activity of the diaphragm. The morphology and metabolism of the diaphragm are usually modified in the presence of COPD: a correlation between this symptoms and a pathological adaptation of breathing can be hypothesized. The management of these conditions should always be multidisciplinary, in order to have a global vision of the patient.

show abstract

Section: Adaptation Of the Diaphragm In Patients Affected By Copdmentioning

confidence: 99%

Depression, anxiety and chronic pain in patients with chronic obstructive pulmonary disease: the influence of breath

Bordoni

Marelli²,

Bruno

et al. 2017

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

show abstract

“…Hopkinson et al 14 did not find any significant difference between nine COPD patients and seven controls, Lu et al 15 studied only three COPD patients and found reduced CMAP amplitudes in two of them. El-Tantawi et al 16 studied 40 COPD patients (all men) and compared them with 27 matched age and height controls. He did not find any significant difference between these two groups in amplitude and the latency of phrenic CMAP (area and duration were not mentioned) using the same recording points that were used by Podnar and Harlander 7 and ourselves.…”

Section: Discussionmentioning

confidence: 99%

Is phrenic nerve conduction affected in patients with difficult-to-treat asthma?

Maranhão

Jardim

Carvalho

et al. 2018

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Objective The aim of this study was to obtain data on phrenic neuroconduction and electromyography of the diaphragm muscle in difficult-to-treat asthmatic patients and compare the results to those obtained in controls. Methods The study consisted of 20 difficult-to-treat asthmatic patients compared with 27 controls. Spirometry, maximal inspiratory and expiratory pressure, chest X-ray, phrenic neuroconduction and diaphragm electromyography data were obtained. Results The phrenic compound motor action potential area was reduced, compared with controls, and all the patients had normal diaphragm electromyography. Conclusion It is possible that a reduced phrenic compound motor action potential area, without electromyography abnormalities, could be related to diaphragm muscle fiber abnormalities due to overload activity.

show abstract

“…Similarly, Hamed et al [21] reported bilateral increase in CMEPL and CMCT in their studied COPD compared to healthy control group as well as decreased DRMT. Further, El-Tantawi et al [22] found peripheral phrenic nerve conduction abnormalities in 42.5% of their studied COPD patients that did not correlate with disease severity. These results are in accordance of the current results and could be explained by increased excitation of motor cortex and corticospinal pathways to the respiratory muscles in the COPD patient [23] and less excitability of intracortical facilitatory circuits at long interstimulus intervals using paired stimulation denoting ceiling effect of motor control output to the respiratory muscles of case of COPD.…”

Section: Discussionmentioning

confidence: 94%

Diaphragmatic Central Motor Conduction Changes In Chronic Obstructive Pulmonary Disease

Shafiek

2019

Preprint

View full text Add to dashboard Cite

16 Background and objectives: Respiratory muscles dysfunction has been reported in 17 COPD. Transcranial magnetic stimulation (TMS) is easy non-invasive that has been 18 used for assessing the respiratory corticospinal pathways particularly of diaphragm. 19 We aimed to study the cortico-diaphragmatic motor system changes in COPD using 20 TMS and to correlate the findings with the pulmonary function.21 Methods: A case control study recruited 30 stable COPD from the out-patient 22 respiratory clinic of Main Alexandria University hospital-Egypt and 17 healthy 23 control subjects who were subjected to spirometry. Cortical conduction of the 24 diaphragm was performed by TMS to all participants followed by cervical magnetic 25 stimulation of the phrenic nerve roots. Diaphragmatic resting motor threshold 26 (DRMT), cortical motor evoked potential latency (CMEPL), CMEP amplitude 27 (CMEPA), peripheral motor evoked potential latency (PMEPL), PMEP amplitude 28 (PMEPA) and central motor conduction time (CMCT) were measured.29 Results: 66.7% of COPD patients had severe and very severe COPD with median age 30 of 59 (55-63) years. There was statistically significant bilateral decrease in DRMT, 31 CMEPA and PMEPA in COPD group versus healthy subjects and significant increase 32 in CMEPL and PMEPL (p <0.01). Left CMCT was significantly prolonged in COPD 33 group versus healthy subjects (p <0.0001) but not right CMCT. Further, there was 34 significant increase in CMEPL and CMCT of left versus right diaphragm in COPD 35 group (p= 0.003 and 0.001 respectively) that inversely correlated with FEV 1 % and 36 FVC% predicted.3 37 Conclusion: Central cortico-diaphragmatic motor system is affected in COPD 38 patients with heterogeneity of both sides that is correlated with pulmonary function. 39 Significance: Coticospinal pathway affection could be a factor for development of 40 diaphragmatic dysfunction in COPD patients accordingly its evaluation could help in 41 personalization of COPD management especially pulmonary rehabilitation programs 42 Keywords: Transcranial magnetic stimulation, corticospinal pathways, phrenic nerve, 43 pulmonary function 44 45 46 4 47 Introduction 48 Chronic obstructive pulmonary disease (COPD) is mainly presented with dyspnea and 49 exercise limitation secondary to irreversible airflow obstruction; however, nowadays 50 COPD is considered as multi-systemic inflammatory disorder rather than simple 51 respiratory disease.[1] Respiratory muscles dysfunction has been reported in COPD 52 compared to healthy elderly individuals [2] and has been implicated in the development 53 of dyspnea. 54 Respiratory muscles, particularly the diaphragm which is considered the main 55 inspiratory muscle, are affected in COPD in two main ways. Firstly, change of shape 56 and geometry of the chest wall secondary to air trapping and hyperinflation in COPD 57 leads to chronic reduction of the apposition zone of the diaphragm [3] and shorten of 58 the diaphragm fiber sarcomere.[4] Secondly, local activation of muscle proteases and 59 ...

show abstract

Phrenic Nerve Conduction Abnormalities Correlate with Diaphragmatic Descent in Chronic Obstructive Pulmonary Disease

Cited by 18 publications

References 36 publications

Depression, anxiety and chronic pain in patients with chronic obstructive pulmonary disease: the influence of breath

Depression, anxiety and chronic pain in patients with chronic obstructive pulmonary disease: the influence of breath

Is phrenic nerve conduction affected in patients with difficult-to-treat asthma?

Diaphragmatic Central Motor Conduction Changes In Chronic Obstructive Pulmonary Disease

Contact Info

Product

Resources

About