Skip to main content
PMC home page
The Journal of Physiology logoLink to The Journal of Physiology
. 1987 Mar;384:109–118. doi: 10.1113/jphysiol.1987.sp016445

Activation of the human diaphragm from the motor cortex.

S C Gandevia 1, J C Rothwell 1
PMCID: PMC1192253  PMID: 3656144

Abstract

1. Rapidly conducting corticofugal pathways were activated by percutaneous electrical stimulation of the motor cortex in normal subjects. The electromyographic response produced in the diaphragm was assessed with recordings via a gastro-oesophageal catheter and the mechanical response was measured as a change in transdiaphragmatic pressure. 2. The mean latency from the cortical stimulus to the muscle action potential in the diaphragm was 12.3 ms. The latency to the diaphragm from stimulation of the cervical spinal cord at the C4 level was 8.0 ms. The mean 'central conduction time' to the phrenic motor nucleus of 4.3 ms (range 4.0-4.6 ms) was similar to that for the deltoid (mean 4.4 ms; range 4.0-4.8 ms) recorded in the same subjects. 3. The largest twitch contractions of the diaphragm were evoked by cortical stimuli near the vertex during inspiration. The amplitude and duration of the electromyographic and mechanical responses often exceeded those produced by a supramaximal stimulus to both phrenic nerves simultaneously. 4. These results provide the first direct evidence that there is a rapidly conducting oligosynaptic pathway from the motor cortex to the human diaphragm.

Full text

PDF
114

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aminoff M. J., Sears T. A. Spinal integration of segmental, cortical and breathing inputs to thoracic respiratory motoneurones. J Physiol. 1971 Jun;215(2):557–575. doi: 10.1113/jphysiol.1971.sp009485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bassal M., Bianchi A. L., Dussardier M. Effets de la stimulation des structures nerveuses centrales sur l'activité des neurones respiratoires chez le chat. J Physiol (Paris) 1981 Sep;77(6-7):779–795. [PubMed] [Google Scholar]
  3. Bassal M., Bianchi A. L. Effets de la stimulation des structures nerveuses centrales sur les actrivités respiratoires efférentes chez le chat. I. Réponses à la stimulation corticale. J Physiol (Paris) 1981 Sep;77(6-7):741–757. [PubMed] [Google Scholar]
  4. Bellemare F., Bigland-Ritchie B. Assessment of human diaphragm strength and activation using phrenic nerve stimulation. Respir Physiol. 1984 Dec;58(3):263–277. doi: 10.1016/0034-5687(84)90003-3. [DOI] [PubMed] [Google Scholar]
  5. COLLE J., MASSION J. Effet de la stimulation du cortex moteur sur l'activité électrique des nerfs phréniques et médians. Arch Int Physiol Biochim. 1958 Nov;66(4):496–514. doi: 10.3109/13813455809084226. [DOI] [PubMed] [Google Scholar]
  6. Cowan J. M., Rothwell J. C., Dick J. P., Thompson P. D., Day B. L., Marsden C. D. Abnormalities in central motor pathway conduction in multiple sclerosis. Lancet. 1984 Aug 11;2(8398):304–307. doi: 10.1016/s0140-6736(84)92683-7. [DOI] [PubMed] [Google Scholar]
  7. Gandevia S. C., McKenzie D. K. Activation of the human diaphragm during maximal static efforts. J Physiol. 1985 Oct;367:45–56. doi: 10.1113/jphysiol.1985.sp015813. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Gandevia S. C., McKenzie D. K. Human diaphragmatic EMG: changes with lung volume and posture during supramaximal phrenic stimulation. J Appl Physiol (1985) 1986 Apr;60(4):1420–1428. doi: 10.1152/jappl.1986.60.4.1420. [DOI] [PubMed] [Google Scholar]
  9. LANDGREN S., PHILLIPS C. G., PORTER R. Minimal synaptic actions of pyramidal impulses on some alpha motoneurones of the baboon's hand and forearm. J Physiol. 1962 Apr;161:91–111. doi: 10.1113/jphysiol.1962.sp006875. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Lipski J., Bektas A., Porter R. Short latency inputs to phrenic motoneurones from the sensorimotor cortex in the cat. Exp Brain Res. 1986;61(2):280–290. doi: 10.1007/BF00239518. [DOI] [PubMed] [Google Scholar]
  11. MERTON P. A. Voluntary strength and fatigue. J Physiol. 1954 Mar 29;123(3):553–564. doi: 10.1113/jphysiol.1954.sp005070. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Marsden C. D., Merton P. A., Morton H. B. Direct electrical stimulation of corticospinal pathways through the intact scalp in human subjects. Adv Neurol. 1983;39:387–391. [PubMed] [Google Scholar]
  13. McKenzie D. K., Gandevia S. C. Phrenic nerve conduction times and twitch pressures of the human diaphragm. J Appl Physiol (1985) 1985 May;58(5):1496–1504. doi: 10.1152/jappl.1985.58.5.1496. [DOI] [PubMed] [Google Scholar]
  14. Merton P. A., Morton H. B. Stimulation of the cerebral cortex in the intact human subject. Nature. 1980 May 22;285(5762):227–227. doi: 10.1038/285227a0. [DOI] [PubMed] [Google Scholar]
  15. Mills K. R., Murray N. M. Electrical stimulation over the human vertebral column: which neural elements are excited? Electroencephalogr Clin Neurophysiol. 1986 Jun;63(6):582–589. doi: 10.1016/0013-4694(86)90145-8. [DOI] [PubMed] [Google Scholar]
  16. NATHAN P. W. THE DESCENDING RESPIRATORY PATHWAY IN MAN. J Neurol Neurosurg Psychiatry. 1963 Dec;26:487–499. doi: 10.1136/jnnp.26.6.487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Planche D., Bianchi A. L. Modification de l'activité des neurones respiratoires bulbaires provoquée par stimulation corticale. J Physiol (Paris) 1972;64(1):69–76. [PubMed] [Google Scholar]
  18. Planche D. Effets de la stimulation du cortex cérébral sur l'activité du nerf phrénique. J Physiol (Paris) 1972;64(1):31–56. [PubMed] [Google Scholar]
  19. Rikard-Bell G. C., Bystrzycka E. K., Nail B. S. The identification of brainstem neurones projecting to thoracic respiratory motoneurones in the cat as demonstrated by retrograde transport of HRP. Brain Res Bull. 1985 Jan;14(1):25–37. doi: 10.1016/0361-9230(85)90174-1. [DOI] [PubMed] [Google Scholar]
  20. Rossini P. M., Di Stefano E., Stanzione P. Nerve impulse propagation along central and peripheral fast conducting motor and sensory pathways in man. Electroencephalogr Clin Neurophysiol. 1985 Apr;60(4):320–334. doi: 10.1016/0013-4694(85)90006-9. [DOI] [PubMed] [Google Scholar]
  21. Rossini P. M., Marciani M. G., Caramia M., Roma V., Zarola F. Nervous propagation along 'central' motor pathways in intact man: characteristics of motor responses to 'bifocal' and 'unifocal' spine and scalp non-invasive stimulation. Electroencephalogr Clin Neurophysiol. 1985 Oct;61(4):272–286. doi: 10.1016/0013-4694(85)91094-6. [DOI] [PubMed] [Google Scholar]
  22. SARNOFF S. J., SARNOFF L. C., WITTENBERGER J. L. Electrophrenic respiration. VII. The motor point of the phrenic nerve in relation to external stimulation. Surg Gynecol Obstet. 1951 Aug;93(2):190–196. [PubMed] [Google Scholar]
  23. Snooks S. J., Swash M. Motor conduction velocity in the human spinal cord: slowed conduction in multiple sclerosis and radiation myelopathy. J Neurol Neurosurg Psychiatry. 1985 Nov;48(11):1135–1139. doi: 10.1136/jnnp.48.11.1135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. WOOLSEY C. N., SETTLAGE P. H., MEYER D. R., SENCER W., PINTO HAMUY T., TRAVIS A. M. Patterns of localization in precentral and "supplementary" motor areas and their relation to the concept of a premotor area. Res Publ Assoc Res Nerv Ment Dis. 1952;30:238–264. [PubMed] [Google Scholar]
  25. Woolsey C. N., Erickson T. C., Gilson W. E. Localization in somatic sensory and motor areas of human cerebral cortex as determined by direct recording of evoked potentials and electrical stimulation. J Neurosurg. 1979 Oct;51(4):476–506. doi: 10.3171/jns.1979.51.4.0476. [DOI] [PubMed] [Google Scholar]

Articles from The Journal of Physiology are provided here courtesy of The Physiological Society

RESOURCES