Abnormalities of Respiratory Control and the Respiratory Motor Unit

Nogués, Martín; Benarroch, Eduardo E.

doi:10.1097/nrl.0b013e318173e830

Cited by 52 publications

(28 citation statements)

References 107 publications

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“…Our findings of an involvement of brainstem neural networks is in agreement with observations by other groups that contributed CSA-CSR to damage or alteration (either direct or indirect) in central respiratory control centres within the brainstem [17], [50], [51]. However, most MRI studies failed to show consistent data of structural cerebral damage in these patients [3].…”

Section: Discussionsupporting

confidence: 92%

“…In fact, the first case report of CSA-CSR described by Cheyne in 1818 concerned a male who suffered from both congestive heart failure and a stroke [16]. Subsequently, the question arose as to whether CSA-CSR was primarily related to cardiac or neurologic dysfunction [5], in particular to dysfunction of respiratory control centers in the brainstem [17]. However, neuroimaging (particularly conventional magnetic resonance imaging (MRI)) almost always fails to identify primary or secondary structural changes of the brainstem in patients with CSA-CSR.…”

Section: Introductionmentioning

confidence: 99%

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Brainstem Involvement as a Cause of Central Sleep Apnea: Pattern of Microstructural Cerebral Damage in Patients with Cerebral Microangiopathy

et al. 2013

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BackgroundThe exact underlying pathomechanism of central sleep apnea with Cheyne-Stokes respiration (CSA-CSR) is still unclear. Recent studies have demonstrated an association between cerebral white matter changes and CSA. A dysfunction of central respiratory control centers in the brainstem was suggested by some authors. Novel MR-imaging analysis tools now allow far more subtle assessment of microstructural cerebral changes. The aim of this study was to investigate whether and what severity of subtle structural cerebral changes could lead to CSA-CSR, and whether there is a specific pattern of neurodegenerative changes that cause CSR. Therefore, we examined patients with Fabry disease (FD), an inherited, lysosomal storage disease. White matter lesions are early and frequent findings in FD. Thus, FD can serve as a "model disease" of cerebral microangiopathy to study in more detail the impact of cerebral lesions on central sleep apnea.Patients and MethodsGenetically proven FD patients (n = 23) and age-matched healthy controls (n = 44) underwent a cardio-respiratory polysomnography and brain MRI at 3.0 Tesla. We applied different MR-imaging techniques, ranging from semiquantitative measurement of white matter lesion (WML) volumes and automated calculation of brain tissue volumes to VBM of gray matter and voxel-based diffusion tensor imaging (DTI) analysis.ResultsIn 5 of 23 Fabry patients (22%) CSA-CSR was detected. Voxel-based DTI analysis revealed widespread structural changes in FD patients when compared to the healthy controls. When calculated as a separate group, DTI changes of CSA-CSR patients were most prominent in the brainstem. Voxel-based regression analysis revealed a significant association between CSR severity and microstructural DTI changes within the brainstem.ConclusionSubtle microstructural changes in the brainstem might be a neuroanatomical correlate of CSA-CSR in patients at risk of WML. DTI is more sensitive and specific than conventional structural MRI and other advanced MR analyses tools in demonstrating these abnormalities.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Brainstem Involvement as a Cause of Central Sleep Apnea: Pattern of Microstructural Cerebral Damage in Patients with Cerebral Microangiopathy

et al. 2013

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“…Hemispheric strokes in the frontal cortex, basal ganglia, or internal capsule may cause respiratory apraxia, with impaired voluntary modulation of breathing amplitude and frequency, leaving patients unable to take a deep breath or hold the breath [47]. Also, the medulla may be less responsive to rising Pco 2 levels during sleep [48]. SDB includes; OSA, central and mixed apnea; is linked with white matter disease on magnetic resonance imaging and silent strokes [49].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Sleep Pattern in Egyptian Elderly with Vascular Dementia

Alloush¹,

Sweed²,

Abdelnaser³

et al. 2019

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Study Objectives: Growing evidence suggests that sleep disturbances is common in vascular dementia (VaD). The goal of the current study is to assess the disturbance in sleep pattern in patients with VaD, and compare it to healthy normally cognitive elderly individuals. We next studied whether there are meaningful differences in the Subjective sleep assessment: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and sleep measurements by polysomnography (PSG) in VaD patients. Study design: Case control study. Subject and methods: Overnight PSG recordings and self-reported sleep measures were obtained from 20 healthy elderly subjects and 20 VaD patients at the sleep laboratory. Results: This study showed abnormal subjective sleep quality in all patients and revealed that the most common sleep complaints among VaD patients were: excessive daytime sleepiness (EDS), sleep disordered breathing (SDB), insomnia, restless leg syndrome (RLS), periodic limb movements (PLMS) and REM behavioral disordered (RBD) respectively. Moreover, patients spent more time in stage I sleep, but less time in slow wave sleep (SWS) and REM sleep compared to control populations, with de-

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“…The pontine group (parabrachial/Kölliker-Fuse complex) controls respiratory timing, receives input from lung stretch receptors, and links respiration to behavioural cues; the dorsal group receives afferents from respiratory chemo and mechanoreceptors, and coordinates respiratory-cardiac reflexes; the ventral group (Bötzinger complex) projects inspiratory neurons, expiratory motor neurons rostrally, and includes a pre-complex generating the respiratory rhythm. Axons descend in the spinal cord in the anterolateral white matter to phrenic, intercostal and abdominal motor neurons, laterally in the high cervical cord near the spinothalamic tract for autonomic function and with the corticospinal tracts for voluntary respiratory control (Nogues and Benarroch, 2008). …”

Section: The Rationale For Tissue Engineering Approaches In the Comentioning

confidence: 99%

Current tissue engineering and novel therapeutic approaches to axonal regeneration following spinal cord injury using polymer scaffolds

Madigan

McMahon

O’Brien

et al. 2009

Respiratory Physiology & Neurobiology

166

151

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This review highlights current tissue engineering and novel therapeutic approaches to axonal regeneration following spinal cord injury. The concept of developing 3-dimensional polymer scaffolds for placement into a spinal cord transection model has recently been more extensively explored as a solution for restoring neurologic function after injury. Given the patient morbidity associated with respiratory compromise, the discrete tracts in the spinal cord conveying innervation for breathing represent an important and achievable therapeutic target. The aim is to derive new neuronal tissue from the surrounding, healthy cord that will be guided by the polymer implant through the injured area to make functional reconnections. A variety of naturally derived and synthetic biomaterial polymers have been developed for placement in the injured spinal cord. Axonal growth is supported by inherent properties of the selected polymer, the architecture of the scaffold, permissive microstructures such as pores, grooves or polymer fibres, and surface modifications to provide improved adherence and growth directionality. Structural support of axonal regeneration is combined with integrated polymeric and cellular delivery systems for therapeutic drugs and for neurotrophic molecules to regionalize growth of specific nerve populations.

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Abnormalities of Respiratory Control and the Respiratory Motor Unit

Abstract: Respiratory dysfunction constitute an early and relatively major manifestation of several neurologic disorders and may be due to an abnormal breathing pattern generation due to involvement of the cardiorespiratory network or more frequently to respiratory muscle weakness.

Cited by 52 publications

References 107 publications

Brainstem Involvement as a Cause of Central Sleep Apnea: Pattern of Microstructural Cerebral Damage in Patients with Cerebral Microangiopathy

Brainstem Involvement as a Cause of Central Sleep Apnea: Pattern of Microstructural Cerebral Damage in Patients with Cerebral Microangiopathy

Assessment of Sleep Pattern in Egyptian Elderly with Vascular Dementia

Current tissue engineering and novel therapeutic approaches to axonal regeneration following spinal cord injury using polymer scaffolds

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