Modulation of Respiratory System by Limb Muscle Afferents in Intact and Injured Spinal Cord

Natalia A Shevtsova, Vitaliy Marchenko, Tatiana Bezdudnaya, Natalia A Shevtsova, Vitaliy Marchenko, Tatiana Bezdudnaya

Abstract

Breathing constantly adapts to environmental, metabolic or behavioral changes by responding to different sensory information, including afferent feedback from muscles. Importantly, not just respiratory muscle feedback influences respiratory activity. Afferent sensory information from rhythmically moving limbs has also been shown to play an essential role in the breathing. The present review will discuss the neuronal mechanisms of respiratory modulation by activation of peripheral muscles that usually occurs during locomotion or exercise. An understanding of these mechanisms and finding the most effective approaches to regulate respiratory motor output by stimulation of limb muscles could be extremely beneficial for people with respiratory dysfunctions. Specific attention in the present review is given to the muscle stimulation to treat respiratory deficits following cervical spinal cord injury.

Keywords: exercise; muscle afferents; muscle stimulation; respiration; spinal cord injury.

Figures

Figure 1
Figure 1
Schematic diagram of possible interactions between locomotor and respiratory systems. Brainstem respiratory network includes medulla and pons (see Section “Overview of Respiratory and Locomotor Networks”). Afferent inputs from limb muscles, joints and tendons are outlined by dashed line.
Figure 2
Figure 2
Simplified hypothetical diagram representing intraspinal connections between locomotor and respiratory spinal circuits. RMn – respiratory motoneuron. LMn – limb motoneuron. X? – shared interneuron that drives/modulates both RMn and LMn and receives afferent feedback from limb muscles. Possible direct inputs to RMn from limb muscle afferents are also shown.
Figure 3
Figure 3
Schematic diagram of cardio-respiratory interactions during exercise. Blue color represents afferent feedback from limb muscles. Red color shows afferent feedback from baro- and lung stretch receptors. NA – nucleus ambiguous; DMV – dorsal motor nucleus of vagus; PGNs – preganglionic neurons; Symp – sympathetic outputs; PSymp – parasympathetic output; X – vagus nerve. Open and filled big circles represent excitatory and inhibitory neuron populations, respectively. Filled small circles show inhibitory inputs, open small arrows indicate excitatory inputs. NTS was moved out from the block presenting brainstem respiratory network to show its inputs and outputs in greater details. Peripheral/central chemoreception was not included for simplicity.

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