Respiratory Neurobiology

Physiology and Clinical Disorders, Part II

1st Edition, Volume 189 - August 26, 2022
Editors: Robert Chen, Patrice G. Guyenet
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 9 1 5 3 2 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 1 5 3 3 - 5

Respiratory Neurobiology: Physiology and Clinical Disorders, Part Two, Volume 189 is one of two volumes on the neurology of breathing. This volume focuses on pathologies attrib… Read more

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Respiratory Neurobiology: Physiology and Clinical Disorders, Part Two, Volume 189 is one of two volumes on the neurology of breathing. This volume focuses on pathologies attributable to abnormalities of the neural control of breathing, breathing problems that may occur in neurological diseases, and the neurological complications of respiratory diseases, while volume one focuses on the neurophysiology of breathing.

Cover image
Title page
Table of Contents
Copyright
Handbook of Clinical Neurology 3rd Series
Foreword
Preface
Contributors
Section I: Assessment of the respiratory system in neurological disorders
Chapter 1: Pulmonary function testing in neuromuscular disease
Abstract
Spirometry
Flow-Volume Loops
Assessment of Lung Volumes Other than Vital Capacity
Assessing Respiratory Muscle Strength
Cough Assessment
Forced Oscillation Technique (Impulse Oscillometry)
Summary
References
Chapter 2: Electrophysiological assessment of respiratory function
Abstract
Introduction
Electrical Phrenic Nerve Conduction Studies
Magnetic Stimulation of the Diaphragm and Phrenic Nerve
Needle Electromyography of the Diaphragm
Ultrasound-Guided Needle Electromyography
Ultrasound for Respiratory Function Assessment
Neurophysiological Assessment of Respiratory Function in Different Diseases
Conclusions
References
Section II: Primary breathing disorders
Chapter 3: Apnea of prematurity and sudden infant death syndrome
Abstract
Introduction
Natural History of Apnea of Prematurity
Characterization of Neonatal Cardiorespiratory Events
Neural Mechanisms of Neonatal Apnea
Physiologic Basis for Therapies
Sudden Infant Death Syndrome (SIDS)
Conclusion
References
Chapter 4: Developmental disorders affecting the respiratory system: CCHS and ROHHAD
Abstract
Introduction to Two Rare Neurocristopathies: CCHS & ROHHAD
Genetic Basis of CCHS & ROHHAD
Additional Genes Involved in Central Hypoventilation
Clinical Presentation and Diagnosis of CCHS & ROHHAD
Pathophysiology of CCHS and ROHHAD
Implications of Respiratory, Cardiovascular, and Cerebrovascular Regulation
Inheritance of PHOX2B Mutations and CCHS Phenotype
The Neuroanatomical Basis of CCHS & ROHHAD
Peripheral Neuroanatomic Findings in CCHS and ROHHAD
Clinical Management
Outcomes
References
Chapter 5: Central sleep apnea
Abstract
Pathophysiologic Determinants of Central Sleep Apnea
Diagnosis and Classification of Central Sleep Apnea
Risk Factors and Associated Conditions
Treatment of Central Sleep Apnea
A Proposed Approach to Select Clinical Scenarios
Conclusions
References
Chapter 6: Obstructive sleep apnea
Abstract
Discovery of OSA
Definition
Epidemiology
Pathogenesis
Complications of Sleep Apnea
Treatment
Acknowledgments
References
Section III: Neurological disorders affecting respiration
Chapter 7: Breathing disturbances in Rett syndrome
Abstract
Introduction
Irregular Breathing and Breathholds in Rett Syndrome
Alteration in the Chemosensory Response
The Role of Neurotransmitters and Neuromodulators in Rett Syndrome
Breathholds, Intermittent Hypoxia, and Oxidative Stress in Rett Syndrome
Breathing Dysfunction and the Coordination With Swallowing
Sleep and Apneas in Rett Syndrome
Conclusion
References
Chapter 8: Sudden unexpected death in epilepsy: Respiratory mechanisms
Abstract
Introduction
Epidemiology of Epilepsy and SUDEP
Clinical Risk Factors for SUDEP
Pathophysiology
Insights from Animal Models of SUDEP
Hypotheses of Postictal Respiratory Depression in SUDEP
The 5-HT System and SUDEP
Forebrain Inhibition of Breathing: Role of the Amygdala
Summary and Future Directions
References
Chapter 9: Multiple Sclerosis and related disorders
Abstract
Introduction
Clinical Overview of Multiple Sclerosis
Disturbances of Respiratory Control in Multiple Sclerosis
Neuromyelitis Optica Spectrum Disorders and Control of Breathing
Conclusion
References
Chapter 10: Stroke and breathing
Abstract
Introduction
Acute Respiratory Changes and Management
Respiratory Dysfunction in Brainstem Stroke
Sleep-Disordered Breathing and Stroke
Respiratory Mechanics after Stroke
Conclusions
References
Chapter 11: Breathing disorders in neurodegenerative diseases
Abstract
Brief Overview of Neurodegenerative Disorders
Pulmonary Function in Neurodegenerative Disorders
Parkinsonian Disorders
Alzheimer's Disease
Huntington's Disease
Spinocerebellar Ataxia
Conclusions and Future Challenges
Acknowledgments
References
Chapter 12: Spinal cord injury and degenerative cervical myelopathy
Abstract
Background
Respiratory Pathophysiology of Spinal Cord Injury
Assessments
Diaphragmatic Function
Diaphragmatic Electromyogram (EMG)
Ultrasound
Phrenic Nerve Conduction
Fluoroscopy
Common Respiratory Dysfunction in the Acute Stage of SCI
Initial Laboratory Assessments
Ongoing Respiratory Assessments
Acute Respiratory Management of SCI
Indications for Mechanical Ventilation
Tracheostomy
Weaning from Ventilation
Noninvasive Mechanical Ventilation
Neuromodulation of Phrenic Nerve and Diaphragm
Respiratory Muscle Training
Respiratory Dysfunction after Degenerative Cervical Myelopathy
Conclusions
References
Chapter 13: Motor neuron, peripheral nerve, and neuromuscular junction disorders
Abstract
Introduction
Causes and Mechanisms of Respiratory Failure
Respiratory Management of Amyotrophic Lateral Sclerosis
Respiratory Management of Guillain–Barré Syndrome
Respiratory Management of Myasthenia Gravis and Congenital Myasthenic Syndromes
Conclusions
References
Chapter 14: Phrenic nerve paralysis and phrenic nerve reconstruction surgery
Abstract
Introduction
Neuromuscular Components of the Respiratory System
Neuromuscular Dysfunction Within the Respiratory System
Diaphragm Dysfunction
Treatment of Phrenic Nerve Injury
Current and Future Directions
References
Online Sources
Section IV: Cardiovascular disorders affecting respiration
Chapter 15: Sleep and breathing disorders in heart failure
Abstract
Introduction
Adverse Cardiovascular and Cerebrovascular Consequences of Sleep Apnea
Mechanisms of Obstructive and Central Sleep Apnea in Heart Failure
Treatment of Sleep Apnea in Heart Failure
Conclusions
References
Chapter 16: Neurological effects of respiratory dysfunction
Abstract
Introduction
Basic Physiology
Respiratory Dysfunction
Neurological Manifestations of Respiratory Dysfunction
Conclusions
References
Chapter 17: Neurologic complications of coronavirus and other respiratory viral infections
Abstract
Introduction
Respiratory Viruses and Other Viruses Causing Respiratory Dysfunction
Respiratory Dysfunction by Viral Infection
Pathophysiologic Mechanisms of Neurologic Involvement in Human Coronavirus Infection
Neurologic Manifestations of Human Coronavirus Infection
Conclusions
References
Section V: Treatment considerations for respiratory dysfunction in neurological disorders
Chapter 18: Noninvasive and invasive mechanical ventilation for neurologic disorders
Abstract
Introduction
Indications for Mechanical Ventilation
Review of Mechanical Ventilation
Priorities for Mechanical Ventilation
Setting the Ventilator
Indications and Targets for Mechanical Ventilation in Specific Neurologic Populations
Liberation from Mechanical Ventilation
Extubation in Neuromuscular Conditions
Conclusion
References
Index

Robert Chen

Dr. Robert Chen received MA and medical degrees (MBBChir) from the University of Cambridge and M.Sc. from the University of Toronto. He undertook Neurology residency at the Western University, and fellowship at the National Institute of Neurological Disorders and Stroke. He is currently Professor of Medicine (Neurology) at the University of Toronto, the Catherine Manson Chair in Movement Disorders, Senior Scientist at the Krembil Brain Institute, a full member of the Institute of Medical Science at the University of Toronto, Editor-in-Chief of the Canadian Journal of Neurological Sciences and Associate Editor for Movement Disorders. His research interests include human motor physiology, brain plasticity and understanding the pathophysiology and development of new treatments for movement disorders such as Parkinson’s disease and dystonia. He has published over 350 research papers with Google Scholar H-index of over 100.

Affiliations and expertise

Professor of Medicine (Neurology), University of Toronto; Senior Scientist, Krembil Research Institute, Toronto, ONT, Canada

Patrice G. Guyenet

Dr. Guyenet is a neuroscientist, Professor of Pharmacology, with a career spanning 42 years on the faculty of the University of Virginia (UVa) School of Medicine (Charlottesville, VA, USA). Born in France, he received his undergraduate education in the basic sciences at Ecole Normale Supérieure, Paris (1967-1971). He earned a Ph.D. in neuropsychopharmacology from College de France, Paris, under the direction of College de France Professor Jacques Glowinski where his scientific career was launched (1972-1975). This was followed by postdoctoral studies in neurophysiology at Yale University (1976-1978) mentored by Dr. GK Aghajanian. Dr. Guyenet joined the faculty of the University of Virginia School of Medicine, Department of Pharmacology in 1978 pursuing a basic research focus on the autonomic nervous system and breathing. His research is a branch of Integrative Neuroscience, a discipline that seeks to understand how the brain processes specific types of information. The laboratory studies how the mammalian brain regulates respiration and blood pressure, two physiological processes that are dysfunctional in highly prevalent diseases (hypertension, obesity, apneic syndromes, heart failure, etc.). Continuously supported by the National Institutes of Health, Heart, Lung and Blood Institute, his research program has contributed to seminal progress in the field. A key advance has been the characterization of a lower brainstem nucleus that senses pH and maintains blood CO2 constant by adjusting lung ventilation (the retrotrapezoid nucleus). This work has given a new impetus to the study of central respiratory chemoreception, a field that is rapidly growing in the US and elsewhere. Dr. Guyenet and collaborators have published 243 articles in refereed scientific journals, including high impact publications such as Science, Nature, and Nature Neuroscience. His influence in the field is reflected by his scientific impact metrics (h-index 99; 28,000 citations). Dr. Guyenet and his lab have received several awards including the NIH-HLBI Merit Award, the Carl Ludwig Distinguished lecture of the American Physiological Society, 2008, and UVa Distinguished Scientist Award, 2011. Additionally, Dr. Guyenet received the Edlich-Henderson Inventor of the Year Award (1996) along with colleagues J. Jagger, R. Pearson and J. Brand granted in recognition of three patents, two of which were successfully commercialized. Along with research, teaching and mentoring has been integral to Dr. Guyenet’s academic contributions. Over four decades Dr. Guyenet mentored 15 PhDs and 24 postdoctoral scholars, many of whom have faculty positions in the US and elsewhere. He has been rewarded many times over by medical students for his teaching contributions including the Medical School Student Basic Sciences Teaching Awards (9 times) and the UVa Medical School Award for Excellence in Teaching (1995, 2003). Dr. Guyenet is especially grateful to his department chairmen, Drs. J. Larner, J. Garrison and D. Bayliss for their unflagging support and the freedom to seek his own path. Most importantly, he acknowledges the immense debt he owes to his enthusiastic, hard-working, and talented collaborators. Finally, Dr. Guyenet thanks profusely everyone who has contributed to these twin volumes on Respiratory Neurobiology and hopes that the final product will be helpful to clinicians and basic scientists alike, as a scholarly reference or, hopefully, as an inspiration to move the field to new heights.

Affiliations and expertise

Professor of Pharmacology, Emeritus, University of Virginia School of Medicine, Charlottesville, VA, United States