Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Physiology and pathophysiology of nerve fibres
- Part II Pain
- Part III Control of central nervous system output
- 18 Synaptic transduction in neocortical neurones
- 19 Cortical circuits, synchronization and seizures
- 20 Physiologically induced changes of brain temperature and their effect on extracellular field potentials
- 21 Fusimotor control of the respiratory muscles
- 22 Cerebral accompaniments and functional significance of the long-latency stretch reflexes in human forearm muscles
- 23 The cerebellum and proprioceptive control of movement
- 24 Roles of the lateral nodulus and uvula of the cerebellum in cardiovascular control
- 25 Central actions of curare and gallamine: implications for reticular reflex myoclonus?
- 26 Pathophysiology of upper motoneurone disorders
- 27 Modulation of hypoglossal motoneurones by thyrotropin-releasing hormone and serotonin
- 28 Serotonin and central respiratory disorders in the newborn
- 29 Are medullary respiratory neurones multipurpose neurones?
- 30 Reflex control of expiratory motor output in dogs
- 31 Abnormal thoraco-abdominal movements in patients with chronic lung disease
- 32 Respiratory rhythms and apnoeas in the newborn
- 33 Cardiorespiratory interactions during apnoea
- 34 Impairment of respiratory control in neurological disease
- 35 The respiratory muscles in neurological disease
- Part IV Development, survival, regeneration and death
- Index
34 - Impairment of respiratory control in neurological disease
from Part III - Control of central nervous system output
Published online by Cambridge University Press: 04 August 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Part I Physiology and pathophysiology of nerve fibres
- Part II Pain
- Part III Control of central nervous system output
- 18 Synaptic transduction in neocortical neurones
- 19 Cortical circuits, synchronization and seizures
- 20 Physiologically induced changes of brain temperature and their effect on extracellular field potentials
- 21 Fusimotor control of the respiratory muscles
- 22 Cerebral accompaniments and functional significance of the long-latency stretch reflexes in human forearm muscles
- 23 The cerebellum and proprioceptive control of movement
- 24 Roles of the lateral nodulus and uvula of the cerebellum in cardiovascular control
- 25 Central actions of curare and gallamine: implications for reticular reflex myoclonus?
- 26 Pathophysiology of upper motoneurone disorders
- 27 Modulation of hypoglossal motoneurones by thyrotropin-releasing hormone and serotonin
- 28 Serotonin and central respiratory disorders in the newborn
- 29 Are medullary respiratory neurones multipurpose neurones?
- 30 Reflex control of expiratory motor output in dogs
- 31 Abnormal thoraco-abdominal movements in patients with chronic lung disease
- 32 Respiratory rhythms and apnoeas in the newborn
- 33 Cardiorespiratory interactions during apnoea
- 34 Impairment of respiratory control in neurological disease
- 35 The respiratory muscles in neurological disease
- Part IV Development, survival, regeneration and death
- Index
Summary
It has proved difficult to attribute precise respiratory function to localized anatomical substrates in man because lesions are rarely isolated and, even with newer imaging techniques, ante-mortem localization is imprecise. Furthermore accurate diagnosis of respiratory insufficiency has led to earlier therapeutic intervention with controlled ventilation. Finally there is probably considerable redundancy and plasticity of neural function where progressive and destructive mass lesions can have little or no functional consequence whilst acute discrete lesions in a similar distribution may lead to profound respiratory impairment.
It has been conventional to consider neural control of respiration to depend on two anatomically and functionally independent pathways (Plum, 1970). Metabolic (automatic) respiration is the homeostatic pathway by which ventilation may be mediated to maintain acid–base status and oxygenation to the metabolic requirements. The behavioural (voluntary) system operates during wakefulness and allows voluntary modulation of respiration in response, for example, to speaking, singing, breath-holding and straining. This has proved a valuable and durable model to explain and predict patterns of respiratory insufficiency; however, there is increasing evidence for interactions between the two systems (Orem & Netick, 1986; Murphy et al., 1990).
Techniques of central motor stimulation and functional imaging have confirmed that the respiratory muscles are activated behaviourally with phrenic motoneurones being controlled by rapidly conducting, oligosynaptic pathways from the contralateral motor cortex. Inspiratory muscles have a direct representation in the primary motor cortex, premotor cortex, supplementary motor area and thalamus, whilst for active expiration the areas are more extensive and involve limbic cortex (Gandevia & Rothwell, 1987; Macefield & Gandevia, 1991; Colebach et al., 1991; Maskill et al., 1991; Ramsay et al., 1993).
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- Information
- The Neurobiology of DiseaseContributions from Neuroscience to Clinical Neurology, pp. 348 - 357Publisher: Cambridge University PressPrint publication year: 1996