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1 Laboratoire de Physiopathologie Respiratoire du Service de Pneumologie, 2 Service Central d'Explorations Fonctionnelles Respiratoires, and 3 Service d'Explorations Fonctionnelles du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, 75651 Paris cédex 13, France
Received 6 September 1995; accepted in final form 15 October 1996.
Straus, Christian, Marc Zelter, Jean-Philippe Derenne,
Bernard Pidoux, Jean-Claude Willer, and Thomas Similowski.
Putative projection of phrenic afferents to the limbic cortex in
humans studied with cerebral-evoked potentials. J. Appl. Physiol. 82(2): 480-490, 1997.
Respiratory
sensations may rely in part on cortical integration of respiratory
afferent information. In an attempt to study such projections, we
recorded evoked potentials at scalp and cervical sites in 10 normal
volunteers undergoing transcutaneous phrenic stimulation (0.1-ms square
pulses, intensity liminal for diaphragmatic activation, series of 600 shocks at 2 Hz). A negative cerebral component of peak latency
(12.79 ± 0.54 ms; N13) was constant, and a negative
spinal component (7.09 ± 1.04 ms; N7) could also be recorded, all
results being reproducible over time. Monitoring of cardiac frequency,
skin anesthesia, and stimulation adjacent to the phrenic nerve made the
phrenic origin of N7 and N13 the foremost hypothesis. Increasing
stimulation frequency and comparison with median nerve stimulation
provided arguments for the neural nature of the signals and their
cerebral origin. Recordings from intracerebral electrodes in a patient
showed a polarity reversal of the evoked potentials at the level of the cingulate gyrus. In conclusion, phrenic stimulation could allow one to
study projections of phrenic afferents to the central nervous system in
humans. Their exact site and physiological meaning remain to be
clarified.
phrenic nerve; diaphragm; cerebral cortex; respiratory afferents; control of breathing; dyspnea
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