Switching of the respiratory phases and evoked phrenic responses produced by rostral pontine electrical stimulation

1. In midcollicular-decerebrate, gallamine-paralysed, vagotomized cats, efferent phrenic discharge was recorded as an indicator of the central respiratory cycle. Electrical stimulation (50-250/sec) delivered in the rostral lateral pontine ;pneumotaxic centre' region (in and near nucleus parabrachialis), and set to occur at specified times in the cycle, produced powerful respiratory effects: (a) at dorsolateral points, inspiratory-facilitatory effects (increase of phrenic discharge, shortening of the expiratory phase); (b) at ventrolateral points, expiratory-facilitatory effects (decrease of phrenic discharge, shortening of the inspiratory phase, lengthening of the expiratory phase).2. At both inspiratory-facilitatory and expiratory-facilitatory points, a single stimulus delivered during the inspiratory phase produced a short-latency (4-7 msec) reduction of phrenic discharge, followed by a wave of increased activity. The short latency of the response indicates the existence of paucisynaptic descending inhibitory pathways. Succeeding stimuli in a high-frequency train produced alternating waves of evoked activity and depression; the form of the responses depended on stimulus frequency and on locus of stimulation.3. At inspiratory-facilitatory points, short stimulus trains (10-30 stimuli) of adequate strength delivered in the middle and late expiratory phase caused early termination of the phase (latency 100-300 msec) and switching to a complete inspiratory phase, in which the phrenic discharge pattern resembled that in a normal inspiratory phase. Similarly, adequate stimulus trains applied at expiratory-facilitatory points during the middle and late inspiratory phase caused early termination of the phase and switching to a complete expiratory phase.4. The threshold for occurrence of each type of phase-switching response depended on stimulus current, frequency, number of stimuli, and time of stimulus delivery. As stimulus trains were delivered later in the phase, the threshold for switching to the succeeding phase was progressively reduced. Moreover, the nature of the evoked effects was a non-linear function of stimulus characteristics: a small increase of stimulus efficacy changed the system's response from (a) moderate shortening of the phase or transient change in phrenic discharge, to (b) complete termination of the phase.5. These results indicate that, as each respiratory phase progresses, there is a steady increase of excitability in systems which promote the onset of the succeeding phase. Further, the existence of a relatively sharp threshold for switching of the respiratory phases suggests that the phase transitions occur when critical levels of excitation and inhibition are reached synchronously in populations of respiratory neurones.     

Augmentation of muscle nociceptive respiratory reflex facilitation by vagal afferents

Vagal influence on the facilitation of phrenic neural activity during respiratory phase-locked, gastrocnemius muscle nerve nociceptive electrical stimulation was examined in anesthetized, glomectomized, paralyzed, and artificially ventilated cats. (1) In the vagi-intact state, respiratory reflex facilitation was characterized by a sharp rise in peak amplitude, maximum rate of rise or slope, and mean rate of rise of integrated phrenic nerve activity. This was greater during inspiratory phase-locked (T1-locked) muscle nerve electrical stimulation than during expiratory phase-locked (TE-locked) muscle nerve electrical stimulation. "Evoked post-inspiratory phrenic activity" during the early expiratory phase was also observed during TE-locked muscle nerve electrical stimulation. (2) Bilateral vagotomy significantly attenuated the respiratory facilitation during both T1- and TE-locked muscle nerve electrical stimulation. In particular, the "evoked post-inspiratory phrenic activity" during TE-locked muscle nerve electrical stimulation was also attenuated or almost completely abolished. (3) Conditioning electrical stimulation of the vagus nerve revealed facilitatory reflexes which co-exist with inspiratory inhibitory reflexes. (4) The "evoked post-inspiratory phrenic activity" during TE-locked muscle nerve electrical stimulation, which was attenuated or abolished after vagotomy, was restored after vagal T1-locked conditioning stimuli combined with TE-locked muscle nerve electrical stimulation. The results suggest that vagal facilitatory reflexes augment the respiratory reflex facilitation during muscle nociceptive stimulation.     

Respiratory effects of stimulation of cell bodies of the A5 region in the anaesthetised rat

To assess the importance of the pontine A5 region in modulating respiratory activity, electric current or microinjections of glutamate (10-30 nl, 1-3 nmol) were used to stimulate discrete zones within this region in the spontaneously breathing, anaesthetised rat. These stimuli evoked an expiratory facilitatory response, consisting of a decrease in respiratory rate (P < 0.01 electrical, P < 0.001 chemical) due to an increase of expiratory time (P < 0.01 in both cases) as measured from recordings of phrenic nerve activity. No changes were observed in inspiratory time. To avoid changes in PCO2, which could modulate the respiratory response, stimulation was also made during artificial ventilation. Under these conditions the expiratory facilitatory response elicited by glutamate was still present (P < 0.05), although its duration was reduced (P < 0.05), as was the magnitude of the phrenic burst (P < 0.05). At all the sites at which electrical stimulation and glutamate injection had evoked a respiratory response, electrical stimulation evoked a concomitant increase in both blood pressure and heart rate. Glutamate injection evoked a pressor response in 21 out of 30 animals. In eight animals the rise in blood pressure was followed by a fall in blood pressure and in one animal, a depressor response was observed. In all cases glutamate evoked an increase in heart rate. The expiratory facilitatory response was not evoked as a consequence of the increase of blood pressure since it was still present after the administration of guanethidine, which abolished the blood pressure changes. As glutamate is believed to excite perikarya rather than axons of passage these data indicate that expiratory facilitatory responses and the accompanying cardiovascular changes are the consequence of activating neurones located within the A5 region. The possible interactions between the A5 region and the medullary respiratory complex in eliciting these changes are discussed.     

Role of the ventrolateral region of the nucleus of the tractus solitarius in processing respiratory afferent input from vagus and superior laryngeal nerves

Summary The role of respiratory neurons located within and adjacent to the region of the ventrolateral nucleus of the tractus solitarius (vlNTS) in processing respiratory related afferent input from the vagus and superior laryngeal nerves was examined. Responses in phrenic neural discharge to electrical stimulation of the cervical vagus or superior laryngeal nerve afferents were determined before and after lesioning the vlNTS region. Studies were conducted on anesthetized, vagotomized, paralyzed and artificially ventilated cats. Arrays of 2 to 4 tungsten microelectrodes were used to record neuronal activity and for lesioning. Constant current lesions were made in the vlNTS region where respiratory neuronal discharges were recorded. The region of the vlNTS was probed with the microelectrodes and lesions made until no further respiratory related neuronal discharge could be recorded. The size and placement of lesions was determined in subsequent microscopic examination of 50 m thick sections. Prior to making lesions, electrical stimulation of the superior laryngeal nerve (4–100 A, 10 Hz, 0.1 ms pulse duration) elicited a short latency increase in discharge of phrenic motoneurons, primarily contralateral to the stimulated nerve. This was followed by a bilateral decrease in phrenic nerve discharge and, at higher currents, a longer latency increase in discharge. Stimulation of the vagus nerve at intensities chosen to selectively activate pulmonary stretch receptor afferent fibers produced a stimulus (current) dependent shortening of inspiratory duration. Responses were compared between measurements made immediately before and immediately after each lesion so that changes in response efficacy due to lesions per se could be distinguished from other factors, such as slight changes in the level of anesthesia over the several hours necessary in some cases to complete the lesions. Neither uni- nor bi-lateral lesions altered the efficacy with which stimulation of the vagus nerve shortened inspiratory duration. The short latency excitation of the phrenic motoneurons due to stimulation of the superior laryngeal nerve was severely attenuated by unilateral lesions of the vlNTS region ipsilateral to the stimulated nerve. Neither the bilateral inhibition nor the longer latency excitation due to superior laryngeal nerve stimulation was reduced by uni- or bi-lateral lesions of the vlNTS region. These results demonstrate that extensive destruction of the region of the vlNTS: a) does not markedly affect the inspiratory terminating reflex associated with electrical stimulation of the vagus nerve in a current range selective for activation of pulmonary stretch receptor afferents, and b) abolishes the short-latency increase, but not the bilateral decrease or longer latency increase in phrenic motoneuronal discharge which follows stimulation of the superior laryngeal nerve. We conclude that respiratory neurons in the region of the vlNTS do not play an obligatory role in the respiratory phase transitions in this experimental preparation. Neurons in the vlNTS region may participate in other reflexes, such as the generation of augmented phrenic motoneuronal discharge in response to activation of certain superior laryngeal or vagus nerve afferents.     

Pre-inspiratory burst in the caudal medulla of rabbits

The activity of 48 respiratory units in the paraolivary region from the middle to the rostral end of the hypoglossal cranial nerve root, and the effect of electrical stimulation and L-glutamate applied to the region on phrenic nerve activity was investigated in 14 rabbits. Electrical stimulation (50 Hz, 0.2 ms current pulses at intensities 5-20 microA) and L-glutamate (30-100 ng) shortened the expiratory time and increased the respiratory rhythm with no change in tidal phrenic nerve activity. Rhythmic activity preceding the phrenic nerve activity (pre-inspiratory burst) was recorded in the paraolivary region. The temporal relationship between the pre-inspiratory (pre-I) burst and the phrenic activity remained constant even when the respiratory frequency was altered by passive lung inflation. These results suggest that structures in the paraolivary region may influence the respiratory rhythm in rabbits and that pre-I burst neurons may play a role in triggering periodic phrenic activity.     

Inspiratory on-switch evoked by stimulation of the mesencephalon: Activity of phrenic and laryngeal motoneurones

Summary In anaesthetized cats (chloralose-urethan) the effects of brief tetanic electrical stimulation (50 to 100 ms) of the mesencephalic central gray matter and reticular formation on the inspiratory on-switch were studied during the expiratory (E) phase on the gross and unitary activities of phrenic, laryngeal inspiratory and laryngeal expiratory nerves. On the inspiratory laryngeal and phrenic nerves, stimulation elicited a short latency gross response concomitant with the train: the inspiratory Primary Response (Prim.R.) which is followed by an inspiratory Patterned Response (Patt.R.) of longer duration which corresponded to the inspiratory on-switch. The Patt.R. generally appeared from the Prim.R. within a latent period (Silent Phase: Sil.P.) as long as 100 ms. On the expiratory laryngeal nerve, stimulation elicited a brief activation (expiratory Prim.R.) concomitant with the beginning of the inspiratory laryngeal Prim.R. and which rapidly stopped as the latter continued during the stimulus train. The inspiratory Prim.R. corresponded to a simultaneous activation of both early and late (so defined during their spontaneous discharge) inspiratory motoneurones. The laryngeal motoneurones were more strongly activated than the phrenic ones. During the inspiratory Patt.R. all the phrenic motoneurones presented a recruitment delay earlier, compared with the spontaneous one, whereas the recruitment drastically changed from an inspiratory laryngeal motoneurone to another. Thus, the two pools of motoneurones presented different properties of activation. During the inspiratory Sil.P. no concomitant expiratory laryngeal activation was observed when most of the inspiratory motoneurones were inactive. As some inspiratory laryngeal motoneurones did not stop firing, the existence of some central respiratory neurones exhibiting a similar persistent activity and subserving the inspiratory on-switch mechanisms may be hypothesized.Supported by CNRS (LA 205 and ATP n 4188) and Fondation pour la Recherche Médicale     

The interaction between reflex apnoea and bradycardia produced by injecting 5-HT into the nodose ganglion of the cat

The apnoea, accompanied by bradycardia and hypotension caused by injection of 5-Hydroxytryptamine (5-HT) into the vascularly isolated nodose ganglion is characterised by intense electrical activity in the internal intercostal muscles. No such activity was recorded when apnoea was provoked by electrical stimulation of the central end of the superior laryngeal nerve.The cardiac slowing induced by 5-HT was less marked when the superior laryngeal nerve was concomitantly stimulated with an intensity sufficient to inhibit the internal intercostal activity.When central respiratory drive was depressed by hypocapnic ventilation nodose ganglion-induced bradycardia was comparable to that provoked during electrical stimulation of the superior laryngeal nerve in eupnoea.Unlike chemoreceptor-induced bradycardia the cardiac slowing caused by nodose ganglion stimulation was not reduced by ramp inflation of the lungs. The results were similar during hypocapnic depression of the Respiratory Centre.These findings suggest that: (a) central expiratory activity contributes to the bradycardia induced by nodose ganglion stimulation, and (b) the inhibition of bradycardia by lung expansion occurs before the neural impulses reach the nucleus ambiguus but does not involve the central respiratory neurones.     

Possible involvement of the facial nucleus in regulation of respiration in rats

The facial nucleus (FN) has been known as a motor nucleus to control the activity of the facial skeletal muscles by its efferent somatic motoneurons. Much less, however, is known about the non-motor control functions of its interneurons. The present study was designed to investigate if the interneurons of the FN participate in controlling rhythmic respiration in the sodium thiopental-anesthetized and vagotomized Sprague-Dawley rats with facial motoneurons retrogradely degenerated with techniques of electrical and chemical stimulation of the FN and extracellular recording of discharge of neurons in the FN. Single pulse stimulation (75-100 microA, 0.2 ms) of the FN during inspiration caused a transient restrain in phrenic discharge. Short train stimulation (75-100 microA, 0.2 ms, 100 Hz, 3-5 pulses) delivered during the early- or mid-term of inspiration augmented the inspiratory duration, but switched the inspiration off when delivered during the later stage of inspiration. Short train stimulation delivered during expiration prolonged the expiratory duration. Continuous stimulation could inhibit the inspiration. Microinjection of kainic acid into the FN caused an augmentation in inspiratory duration and amplitude and in expiratory duration. These data indicate that the interneurons of the FN might participate in the modulation of respiration. Different discharge patterns of interneurons in the FN, interestingly some respiratory related patterns, were observed, which provide a possible structural basis for the role of the FN in respiratory regulation.     

Characterization of hindlimb muscle afferents involved in ventilatory effects observed in decerebrate and spinal preparations

Summary Neurogenic changes of phrenic activity have previously been observed during periodic passive motions of one hindlimb in decorticate, unanaesthetized and curarized rabbit preparations before and after high spinal transection (Palisses et al. 1988). In decerebrate and spinal preparations, we aimed to determine, through rhythmic electrical stimulation of hindlimb muscle nerves, which muscle afferents are involved in these effects. In decerebrate preparations, these electrical stimulations (trains of shocks at 80 Hz for 300 ms every second for 20 s) produced ventilatory effects when group I+II afferent fibres of either flexor or extensor nerves were stimulated together and more powerful changes as soon as group III fibres were recruited. Stimulation of group I fibres alone induced no such effects. When present, these changes in respiratory activity consisted of a maintained decrease of the respiratory period due to both inspiratory and expiratory time shortening; in addition, the amplitude of the phrenic bursts greatly increased at the onset of electrical stimulation. After spinal transection at C2 level and pharmacological activation by nialamide and DOPA, only short-lasting phrenic bursts developed spontaneously; the electrical stimulation of group II and mainly group III flexor afferent fibres induced large amplitude phrenic activity whereas the stimulation of the same extensor afferents was relatively ineffective. The activation of phrenic motoneurones during group III flexor afferent stimulation was closely linked to each 300 ms period of stimulation. While the phrenic effects obtained in the spinal preparations by natural and by electrical periodic stimulation are quite similar to each other, those produced in decerebrate preparations differ substantially. It is concluded that the regulation of phrenic activity in decerebrate and spinal rabbit preparations by hindlimb proprioceptive afferents involves different muscle receptors; perhaps joint proprioceptors for the medullary resetting and muscle receptors connected to group III afferent fibres for the spinal reflex activation of phrenic motoneurones.     

The importance of timing on the respiratory effects of intermittent carotid body chemoreceptor stimulation

1. The respiratory response, measured directly as tidal volume or indirectly by using integrated peak phrenic activity, to brief intermittent chemical stimulation or depression of the carotid body was determined in anaesthetized cats. Recordings of carotid sinus nerve impulses allowed precise timing of the stimulus.2. Stimulation of the carotid body had a rapid effect on air flow, tidal volume and phrenic discharge rate only if given during inspiration. Increases in tidal volume and peak phrenic discharge occurred only if stimulation was applied during the last half of inspiration. Stimulation during expiration had no effect on the form or magnitude of subsequent breaths.3. Depression of the carotid body by NH(4)OH led to decreased tidal volume and phrenic discharge if it occurred during inspiration but had no effect if it occurred during expiration.4. Stimuli in expiration led to a prolongation of expiration. Stimuli in late inspiration caused prolongation of both inspiration and expiration.5. All of the effects noted were eliminated by bilateral carotid body denervation.6. The findings are similar to those following electrical stimulation of the carotid sinus nerve and are attributable to modulation of carotid body signals by the central respiratory neurones.     

Responses of ventral respiratory neurones in the rat to vagus stimulation and the functional division of expiration.

In anaesthetized rats, extracellular and intracellular recordings were taken from 106 respiratory neurones in the intermediate region of the nucleus ambiguus. We observed unprovoked shortening of expiratory time accompanied, in all classes of respiratory neurone, by the elimination of the changes in membrane potential that were characteristic of stage II expiration. The demonstration of the elimination of stage II expiration in both the rat and cat strongly supports the functional division of expiration into stage I expiration (post-inspiration) and stage II expiration. In order to identify the neurones in the rat that receive inputs from vagal afferents and modulate the central respiratory rhythm, we examined whether any respiratory neurones responded to stimulation of the vagus nerve. Some post-inspiratory and stage II expiratory neurones responded. The short latency (< 2 ms) of four of the responses indicates that some vagal afferents act on post-inspiratory neurones via a disynaptic pathway. While repetitive stimulation of the vagus nerve could inhibit the phrenic rhythm, it appears that most inspiratory neurones in the intermediate region of the nucleus ambiguous complex are not directly involved in integrating the information from vagal afferents with the central respiratory rhythm.     

D1-dopamine receptor blockade slows respiratory rhythm and enhances opioid-mediated depression

Previous studies indicate that dopamine modulates the excitability of the respiratory network and its susceptibility to depression by exogenous opioids, but the roles of different subtypes of dopamine receptor in these processes are still uncertain. In this study, D1-dopamine receptor (D1R) involvement in dopaminergic modulation of respiratory rhythm and mu-opioid receptor mediated depression were investigated in pentobarbital-anesthetized cats. Intravenous administration of the D1R blocker SCH-23390 (100-200 microg/kg) slowed phrenic nerve and expiratory neuron respiratory rhythms by prolonging the inspiratory and expiratory phases. Phrenic nerve discharge intensity also increased more gradually during the inspiratory phase. SCH-23390 (150 microg/kg) also enhanced dose-dependent depression of phrenic nerve and expiratory neuron excitability, as well as rhythm disturbances, produced by the mu-opioid receptor agonist fentanyl (2-20 microg/kg, i.v.). The results suggest an important role for the D1-subtype of receptor in respiratory rhythm modulation, and indicate that this type of receptor participates in dopaminergic compensatory mechanisms directed against opioid-mediated network depression.     

Electrical stimulation of arterial and central chemosensory afferents at different times in the respiratory cycle of the cat: II. Responses of respiratory muscles and their motor nerves

The response patterns of the electrical activity of the respiratory motor nerves and muscles to brief electrical stimulation of the arterial and the intracranial chemosensory afferents were studied in anesthetized cats. Stimulation during inspiration increased the activity of phrenic nerve and the inspiratory muscles (intercostal, diaphragm) with a latency of 15–25 ms, whereas expiratory muscle activity in the following expiration remained almost unaltered. Stimulation during expiration increased the activity of expiratory nerves and muscles (intercostal, abdominal) after a delay of 80–120 ms. The later the stimulation occurred in the insor expiratory period the larger the increase in amplitude and in steepness of rise of the respective integrated activity in respiratory nerves and muscles. Stimulation in early inspiration shortened the discharge period of inspiratory muscles, whereas excitation in early expiration caused an earlier onset and prolonged the activity in the expiratory muscles. Stimulation in the late phase of ins- or expiration prolonged the discharge of the respective nerves and muscles. Both the arterial (carotid sinus nerve, CSN, and aortic nerve, AN) and intracranial chemosensory (VM) afferents stimuli were able to affect both the inspiratory and the expiratory mechanisms. The restriction of the effects to the phase of the stimulus suggests a mechanism by which these afferents, when activated during inspiration, effectively project only to inspiratory neurones, and vice versa for expiration.Supported by the Deutsche Forschungsgemeinschaft, SFB 114 Bionach     

The medial temporal lobe in encoding,retention, retrieval and interhemispheric transfer of visual memory in primates

Low-level electrical stimulation through electrodes in the medial temporal lobe (MTL) was used to disrupt the performance of chiasm-split macaques working in a delayed matching-to-sample (DMS) visual memory task. The stimulation was below afterdischarge threshold and did not distract the animals. Nonetheless, stimulation caused severe deficits when delivered either during encoding or retrieval stages. Substantially less deficit appeared when stimulation was delivered during the retention interval. Stimulation levels which led to significant disruption on the DMS task had no effect on a discrimination task using the same kinds of images. Unilateral electrical stimulation delivered to MTL in one hemisphere during encoding and to MTL in the other hemisphere during retrieval produced an effective disruption, suggesting that the unilateral stimulation during the encoding period disrupts the encoding on that side while unilateral stimulation delivered to the opposite side during the retrieval period prevents the retrieval of the (now unilateral) memory. This suggestion is supported by control experiments in which significantly less disruption was caused by unilateral electrical stimulation delivered during both the encoding and the retrieval period if the stimulation was delivered to the same side in both periods. The electrical stimulation was further used to determine that interhemispheric access by one hemisphere to memories placed in the other was excellent. This was done, in these split-chiasm monkeys, by using unilateral stimulation to limit memory formation to just one hemisphere, then testing interhemispheric access by routing the test through the ignorant hemisphere (using just the ipsilateral eye). Successful interhemispheric access was obtained with either the anterior commissure or with the splenium of the corpus callosum (the other interhemispheric forebrain pathways having been cut). The electrical stimulation was also used to determine that the visual inputs even though entering via just one eye and one hemisphere, lead to bilateral memory formation. In this case each hemisphere was tested separately during retrieval by delivering disruptive levels of the electrical stimulation to the MTL of the other hemisphere.     

Excitatory interactions between phrenic motoneurons in the cat

Summary 1. Interactions between phrenic motoneurons have been analysed in anaesthetized, paralyzed cats after C3 to C7 deafferentation. Effects of electrical stimulation of the C5 phrenic axons have been studied on thin filaments dissected from the stimulated nerve. Repetitive stimulation could elicit, after the primary direct response of the stimulated axons, a secondary response named Recurrent Response, RR. 2. RRs have been obtained in 117/186 phrenic axons. They appear sporadically (mean occurrence: 3.75 RRs elicited by 100 shocks of stimulation) at a constant latency. They originate from a spinal mechanism since they persist after C2 transection and disappear after section of the ventral roots. 3. The mechanism responsible for RR shows spatial and temporal facilitation. The RR probability increases with the number of antidromically invaded motoneurons as revealed by changes either of stimulation intensity or of central respiratory drive. However, RR could be evoked in a motoneuron without an antidromic volley in its axon. 4. Systemic injections of nicotinic blocking drugs such as dihydro--erytroidin or mecamylamine decrease or suppress the occurrence of RR; therefore, cholinergic synapses are involved in the RR generating process. 5. RR are assumed to be due to direct excitatory interactions between homonymous motoneurons. Recurrent axon collaterals impinging directly on neighbouring motoneurons would link together the different motoneurons of the phrenic pool. The functional significance of this phenomenon is discussed.     

The importance of timing on the respiratory effects of intermittent carotid sinus nerve stimulation

1. The respiratory response, measured directly as tidal volume or indirectly by using integrated peak phrenic activity, to intermittent electrical stimulation of the carotid sinus nerve was determined in anaesthetized cats.2. Stimulation at rates of 20-25 Hz for 0.5 sec had a rapid effect, increasing inspiratory airflow and phrenic discharge, but only if applied during inspiration. An increase in tidal volume or peak level of integrated phrenic discharge occurred only if the stimulus was exhibited during the second half of inspiration. Continuous stimulation had no greater effect on size or frequency of breathing than did intermittent inspiratory stimuli alone. Stimulation during expiration had no effect on the form or magnitude of subsequent breaths.3. Stimuli in expiration led to a prolongation of expiration. Stimuli in late inspiration caused a prolongation of both inspiration and expiration. Because of these effects, the respiratory rate could be changed by stimulation; in some instances entrainment of respiration by the intermittent carotid sinus nerve stimuli occurred.4. The findings are attributable to modulation of incoming carotid sinus nerve information by the central respiratory neurones, which use primarily that which arrives during inspiration. They show a possible mechanism by which oscillating signals may have a different effect than their mean level would indicate.     

Respiratory response to mechanical stimulation of the gallbladder

Since stimuli from abdominal or pelvic viscera can affect respiratory muscle function, we hypothesized that mechanical stimulation of the gallbladder would result in inhibition of motor activity to the diaphragm and to upper airway muscles. We studied 12 decerebrate, vagotomized, paralyzed, artificially ventilated cats and recorded hypoglossal (HG) and phrenic (PHR) nerve activities while applying 600-1000 g of traction on the gallbladder during four respiratory cycles. Traction resulted in an initial reduction of PHR activity to 87.6+/-15.0% (mean+/-S.D.% of its baseline value), a reduction of HG activity to 74.2+/-27.5% and a lengthening of expiratory time to 178.8+/-81.0%. Subsequently, PHR activity and expiratory time returned toward control values, while HG remained diminished, at 66.4+/-19.1%. Our results show that mechanical stimulation of the gallbladder results in a respiratory inhibition with a disproportionate reduction in HG activity relative to PHR discharge. We speculate that gallbladder stimulation by contractions or surgery may compromise breathing by inhibition of phrenic discharge and upper airway obstruction.     

Effects of Auditory Stimulation on Respiration

Each of 40 college students received 6 presentations of white noise at an intensity of either SO or 110 dB during either inspiration or expiration. Changes in tidal volume, inspiratory period, and expiratory period elicited by that stimulation were studied. Auditory stimulation produced respiratory changes which could be regarded conveniently as two phasic responses. We labeled these responses the initial phasic response and the delayed phasic response. The initial response was limited to the respiratory period during which stimulation was delivered, it consisted of a brief inspiratory movement which increased the speed of inspiratory periods during which it occurred but decreased the speed of expiratory periods during which it occurred. In either case, the initial phasic response increased ventilation. The delayed phasic response was an increase both in speed and tidal volume of respiratory cycles subsequent to the period during which stimulation was delivered. Like the initial response, the delayed response increased ventilation. The effects of the delayed response were more widespread when stimulation was delivered during expiration rather than during inspiration. Stimulus intensity and stimulus repetition respectively potentiated and attenuated both the initial and the delayed phasic response. The findings are compared with those of earlier research on respiratory changes elicited by auditory stimulation.     

Reflex recruitment of medullary gasping mechanisms in eupnoea by pharyngeal stimulation in cats.

1. Mechanical stimulation of the naso- and oropharynx causes the replacement of the eupnoeic ventilatory pattern by a brief, but large, burst of activity of the phrenic nerve. Our purpose was to define whether these changes in phrenic activity represent a switch to gasping. 2. In decerebrate, vagotomized, paralysed and ventilated cats, mechanical stimulation of the pharynx was performed during eupnoea, apneusis and gasping. The latter two ventilatory patterns were produced by ventilating the experimental animal with 1.0% carbon monoxide in air or with 100% nitrogen. Eupnoea could be re-established by a recommencement of ventilation with oxygen. 3. The rate of rise of phrenic activity and its peak height were much greater following mechanical stimulation of the pharynx than the phrenic bursts of eupnoea or apneusis. The durations of phrenic burst and the period between these were much less following pharyngeal stimulation. In contrast, these variables of phrenic activity were the same during pharyngeal stimulation and in gasping. 4. Previous studies had established that activity within a region of the lateral tegmental field of medulla is critical for the manifestation of gasping. Hence, electrical stimulation of this region during gasping elicits premature gasps whereas its ablation irreversibly eliminates gasping. 5. We positioned a multibarrelled pipette in the critical medullary region for gasping. Its location was verified, once gasping was established in hypoxia or anoxia, by the elicitation of premature gasps following electrical stimulation. Neurons in this region were destroyed by microinjections of the neurotoxin kainic acid; in a few experiments the region was destroyed by electrolytic lesions. 6. Following destruction of the region of the lateral tegmental field, gasping could no longer be provoked in anoxia. In contrast, the eupnoeic pattern of phrenic activity continued. However, mechanical stimulation of the pharynx no longer caused any changes in the on-going pattern of phrenic activity. 7. We conclude that mechanical stimulation of the pharynx elicits a powerful reflex by which eupnoea is suppressed and gasping is elicited. Stated differently, the changes in phrenic activity during this pharyngeal stimulation in fact represent gasps. 8. Gasps are dependent upon activity within a region of the lateral tegmental field of the medulla. This region plays no role in the neurogenesis of eupnoea. Hence, our results provide additional support for the concept that there are multiple sites for ventilatory neurogenesis in the mammalian brainstem.     

Restoration of respiratory muscle function following spinal cord injury. Review of electrical and magnetic stimulation techniques

Respiratory complications are a leading cause of morbidity and mortality in patients with spinal cord injury. Several techniques, currently available or in development, have the capacity to restore respiratory muscle function allowing these patients to live more normal lives and hopefully reduce the incidence of respiratory complications. Bilateral phrenic nerve pacing, a clinically accepted technique to restore inspiratory muscle function, allows patients with ventilator dependent tetraplegia complete freedom from mechanical ventilation. Compared to mechanical ventilation, phrenic nerve pacing provides patients with increased mobility, improved speech, improved comfort level and reduction in health care costs. The results of clinical trials of laparoscopically placed intramuscular diaphragm electrodes suggest that diaphragm pacing can also be achieved without the need for a thoracotomy and associated long hospital stay, and without manipulation of the phrenic nerve which carries a risk of phrenic nerve injury. Other clinical trials are being performed to restore inspiratory intercostal function. In patients with only unilateral phrenic nerve function who are not candidates for phrenic nerve pacing, combined intercostal and unilateral diaphragm pacing appears to provide benefits similar to that of bilateral diaphragm pacing. Clinical trials are also underway to restore expiratory muscle function. Magnetic stimulation, surface stimulation and spinal cord stimulation of the expiratory muscles are promising techniques to restore an effective cough mechanism in this patient population. These techniques hold promise to reduce the incidence of respiratory tract infections, atelectasis and respiratory failure in patients with spinal cord injury and reduce the morbidity and mortality associated with these complications.