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Unaltered respiratory-related evoked potentials after acute diaphragm dysfunction in humans

¹ Laboratoire de Physiopathologie Respiratoire, Service de Pneumologie, and ² Service Central d'Explorations Fonctionnelles Respiratoires, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, ³ Unité Propre de Recherche de l'Enseignement Supérieur EA 2397, Université Pierre et Marie Curie Paris VI, Paris, France and ⁴ Servizio di Medicina Interna 1, Spedali Civili, and Universita di Brescia, Brescia, Italy

CORRESPONDENCE: T. Similowski, Laboratoire de Physiopathologie Respiratoire, Service de Pneumologie et de Réanimation, Groupe Hospitalier Pitié-Salpêtriêre, 47–83, Bd de l'Hôpital, 75651, Paris Cedex 13, France. Fax: 33 142176708. E-mail: thomas.similowski@psl.ap-hop-paris.fr

Keywords: diaphragm, dyspnoea, fatigue, respiratory muscles, respiratory-related evoked potentials, respiratory sensation

Received: March 4, 2003
Accepted June 16, 2003

This study was supported by Contrat de recherche triennal "Legs Poix" de la Chancellerie des Universités de Paris, and Association pour le Développement et l'Organisation de la Recherche en Pneumologie (ADOREP), Paris, France.

Respiratory muscles play an important role in the origin of respiratory sensations. Data dissecting the role of the diaphragm and other inspiratory muscles are scarce. This study aimed to determine the impact of diaphragm dysfunction following inspiratory resistive loading on respiratory-related evoked potentials considered as a neurophysiological substrate of certain types of respiratory sensations.

Altogether, nine subjects aged 25–50 yrs (six females) participated in the study. Transdiaphragmatic pressure output of cervical magnetic stimulation (with subdivision in oesophageal and gastric component), and respiratory-related evoked potentials (C3 and C4 derivations in the international 10–20 system) following mid-inspiratory occlusions were studied before and after an inspiratory-resistive loading challenge.

Predominant diaphragm dysfunction was observed in seven subjects (average 28% reduction in transdiaphragmatic pressure, from 27.25–19.91 cmH₂0, with increased oesophageal-to-gastric pressure ratio). The latencies and amplitudes of all the components of the respiratory-related evoked potentials were unchanged.

The study concluded that predominant diaphragm fatigue does not affect respiratory-related evoked potentials.

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