Limbic and paralimbic respiratory modulation: From inhibition to enhancement.
Limbic and paralimbic respiratory modulation: From inhibition to enhancement.
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边缘和边缘附近的呼吸调节：从抑制到增强。
DOI：
10.1111/epi.17244
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发表时间：
2022-07
期刊：
影响因子：
5.6
通讯作者：
Lacuey, Nuria
中科院分区：
文献类型：
--
作者：
Chaitanya, Ganne;Hampson, Johnson P.;Toth, Emilia;Hupp, Norma J.;Hampson, Jaison S.;Mosher, John C.;Pati, Sandipan;Lhatoo, Samden D.;Lacuey, Nuria
增加对皮质结构在呼吸控制中的作用的理解可能有助于理解癫痫引起的呼吸功能障碍导致癫痫猝死（SUDEP）。本研究的目的是表征电刺激（ES）的呼吸反应，包括呼吸抑制和增强。我们前瞻性招募了19例从2015年6月至2018年6月接受立体定向EEG评价的顽固性癫痫患者。入选标准为年龄≥18岁且ES适用于作为术前评估一部分的发作发作或功能皮层临床标测的患者。在50 Hz、0.2 ms和1-10 mA电流强度下进行ES。在所有患者中采样的共同脑区域是杏仁核（AMY）、海马（HG）、前扣带回（CING）、眶额皮质（OrbF）、颞新皮质（TNC）、颞极（TP）和内嗅皮质（ERC）。进行了755次刺激。呼吸信号的定量分析，在ES期间，使用Breathlasts呼吸波形分析工具箱进行呼吸频率（BR）、深度（TV）和每分钟通气量（MV）的变化。在刺激期间连续监测心电图、动脉血氧饱和度、潮气末和经皮二氧化碳、鼻气流以及腹部和胸部体积描记术。电刺激TP和CING（<3 mA的低电流强度）可增加TV和MV。在7- 10 mA时，CING使TV和MV降低。另一方面，刺激内侧颞叶结构如AMY和HG时，TV和MV降低。呼吸变化依赖于刺激强度。侧颞、内嗅和眶额皮质对呼吸没有影响。这些发现表明，呼吸暂停以外的呼吸反应，可以诱导ES。识别两个区域，颞极和前扣带回，呼吸增强可能是重要的，为未来的发展战略，预防SUDEP铺平了道路。
Increased understanding of the role of cortical structures in respiratory control may help the understanding of seizure-induced respiratory dysfunction that leads to sudden death in epilepsy (SUDEP). The aim of this study was to characterize respiratory responses to electrical stimulation (ES), including inhibition and enhancement of respiration. We prospectively recruited 19 consecutive patients with intractable epilepsy undergoing stereotactic EEG evaluation from June 2015 to June 2018. Inclusion criteria were patients ≥18 years and in whom ES was indicated for clinical mapping of ictal onset or eloquent cortex as part of the presurgical evaluation. ES was carried out at 50 Hz, 0.2 ms and 1–10 mA current intensity. Common brain regions sampled across all patients were- amygdala (AMY), hippocampus (HG), anterior cingulate gyrus (CING), orbitofrontal cortex (OrbF), temporal neocortex (TNC), temporal pole (TP) and entorhinal cortex (ERC). 755 stimulations were conducted. Quantitative analysis of breathing signal i.e., changes in breathing rate (BR), depth (TV), and minute ventilation (MV) was carried out during ES using the BreathMetrics breathing waveform analysis toolbox. Electrocardiogram, arterial oxygen saturation, end-tidal and transcutaneous carbon dioxide, nasal airflow, and abdominal and thoracic plethysmography were continuously monitored during stimulations. Electrical stimulation of TP and CING (at lower current strengths <3mA) increased TV and MV. At 7–10mA, CING decreased TV and MV. On the other hand, decreased TV and MV occurred with stimulation of mesial temporal structures such as AMY and HG. Breathing changes were dependent on stimulation intensity. Lateral temporal, entorhinal, and orbitofrontal cortices did not affect breathing either way. These findings suggest that breathing responses other than apnea can be induced by ES. Identification of two regions, the temporal pole and anterior cingulate gyrus, for enhancement of breathing may be important in paving the way to future development of strategies for prevention of SUDEP.
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影响因子：
2.6
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