Journal of Applied Physiology AJP: Lung Cellular and Molecular Physiology
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J Appl Physiol 82: 1190-1199, 1997;
8750-7587/97 $5.00
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Journal of Applied Physiology
Vol. 82, No. 4, pp. 1190-1199, April 1997
EXERCISE AND MUSCLE

Comparison of magnetic and electrical phrenic nerve stimulation in assessment of phrenic nerve conduction time

Thomas Similowski, Selma Mehiri, Alexandre Duguet, Valérie Attali, Christian Straus, and Jean-Philippe Derenne

Service de Pneumologie et Réanimation and Laboratoire de Physiopathologie Respiratoire, Groupe Hospitalier Pitié-Salpêtrière, 75651 Paris Cedex 13, France

Received 1 August 1996; accepted in final form 19 December 1996.

Similowski, Thomas, Selma Mehiri, Alexandre Duguet, Valérie Attali, Christian Straus, and Jean-Philippe Derenne. Comparison of magnetic and electrical phrenic nerve stimulation in assessment of phrenic nerve conduction time. J. Appl. Physiol. 82(4): 1190-1199, 1997.---Cervical magnetic stimulation (CMS), a nonvolitional test of diaphragm function, is an easy means for measuring the latency of the diaphragm motor response to phrenic nerve stimulation, namely, phrenic nerve conduction time (PNCT). In this application, CMS has some practical advantages over electrical stimulation of the phrenic nerve in the neck (ES). Although normal ES-PNCTs have been consistently reported between 7 and 8 ms, data are less homogeneous for CMS-PNCTs, with some reports suggesting lower values. This study systematically compares ES- and CMS-PNCTs for the same subjects. Surface recordings of diaphragmatic electromyographic activity were obtained for seven healthy volunteers during ES and CMS of varying intensities. On average, ES-PNCTs amounted to 6.41 ± 0.84 ms and were little influenced by stimulation intensity. With CMS, PNCTs were significantly lower (average difference 1.05 ms), showing a marked increase as CMS intensity lessened. ES and CMS values became comparable for a CMS intensity 65% of the maximal possible intensity of 2.5 Tesla. These findings may be the result of phrenic nerve depolarization occurring more distally than expected with CMS, which may have clinical implications regarding the diagnosis and follow-up of phrenic nerve lesions.

diaphragm; cervical magnetic stimulation; phrenic latency

0161-7567/97 $5.00 Copyright © 1997 the American Physiological Society




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