Excitation of upper cervical inspiratory neurons by inspiratory neurons of the nucleus retroambigualis in the cat

Targeted activation of spinal respiratory neural circuits

Spinal interneurons which discharge in phase with the respiratory cycle have been repeatedly described over the last 50 years. These spinal respiratory interneurons are part of a complex propriospinal network that is synaptically coupled with respiratory motoneurons. This article summarizes current knowledge regarding spinal respiratory interneurons and emphasizes chemical, electrical and physiological methods for activating spinal respiratory neural circuits. Collectively, the work reviewed here shows that activating spinal interneurons can have a powerful impact on spinal respiratory motor output, and can even drive rhythmic bursting in respiratory motoneuron pools under certain conditions. We propose that the primary functions of spinal respiratory neurons include 1) shaping the respiratory pattern into the final efferent motor output from the spinal respiratory nerves; 2) coordinating respiratory muscle activation across the spinal neuraxis; 3) coordinating postural, locomotor and respiratory movements, and 4) enabling plasticity of respiratory motor output in health and disease.

The crossed phrenic phenomenon

The cervical spine is the most common site of traumatic vertebral column injuries. Respiratory insufficiency constitutes a significant proportion of the morbidity burden and is the most common cause of mortality in these patients. In seeking to enhance our capacity to treat specifically the respiratory dysfunction following spinal cord injury, investigators have studied the "crossed phrenic phenomenon", wherein contraction of a hemidiaphragm paralyzed by a complete hemisection of the ipsilateral cervical spinal cord above the phrenic nucleus can be induced by respiratory stressors and recovers spontaneously over time. Strengthening of latent contralateral projections to the phrenic nucleus and sprouting of new descending axons have been proposed as mechanisms contributing to the observed recovery. We have recently demonstrated recovery of spontaneous crossed phrenic activity occurring over minutes to hours in C₁-hemisected unanesthetized decerebrate rats. The specific neurochemical and molecular pathways underlying crossed phrenic activity following injury require further clarification. A thorough understanding of these is necessary in order to develop targeted therapies for respiratory neurorehabilitation following spinal trauma. Animal studies provide preliminary evidence for the utility of neuropharmacological manipulation of serotonergic and adenosinergic pathways, nerve grafts, olfactory ensheathing cells, intraspinal microstimulation and a possible role for dorsal rhizotomy in recovering phrenic activity following spinal cord injury.

Modulation of respiratory output by cervical epidural stimulation in the anesthetized mouse

Respiration is produced and controlled by well-characterized brain stem nuclei, but the contributions of spinal circuits to respiratory control and modulation remain under investigation. Many respiratory studies are conducted in in vitro preparations (e.g., brain stem slice) obtained from neonatal rodents. While informative, these studies do not fully recapitulate the complex afferent and efferent neural circuits that are likely to be involved in eupnea (i.e., quiet breathing). To begin to investigate spinal contributions to respiration, we electrically stimulated the cervical spinal cord during unassisted respiration in anesthetized, intact mice. Specifically, we used epidermal electrical stimulation at 20 Hz and varied current intensity to map changes in respiration. Stimulating at 1.5 mA at cervical level 3 (C3) consistently caused a significant increase in respiratory frequency compared with prestimulation baseline and when compared with sham stimulations. The increase in respiratory frequency persisted for several minutes after epidural stimulation ceased. There was no change in tidal volume, and the estimated minute ventilation was increased as a consequence of the increase in respiratory frequency. Sigh frequency also increased during epidural stimulation at C3. Neither the increase in respiratory frequency nor the increase in sighing were observed after stimulation at other dorsal cervical levels. These findings suggest that the spinal circuits involved in the modulation of eupnea and sighing may be preferentially activated by specific endogenous inputs. Moreover, the cervical spinal cord may play a role in respiratory modulation that affects both eupneic respiration and sigh production in intact, adult mice.

Spontaneous respiratory rhythm generation in in vitro upper cervical slice preparations of neonatal mice

Isolated upper cervical slice preparations were prepared from neonatal mice to examine whether spontaneous respiratory activity could be generated in the preparations. By using brainstem-spinal cord preparations, we first recorded from the cervical C1-C2 and C4 ventral roots rhythmic bursts which were synchronized with respiratory burst activity of the hypoglossal (XIIth) nerve. Following transection just above the C1 segment, smaller and slower rhythmic bursts still persisted in the C1/C2 ventral roots and these were synchronized with those in the C4 ventral root. The present result, that a bursting rhythm remained in the C1/C2 slices, suggests that the spinal neuronal circuit for generating respiratory rhythm is localized in the upper cervical segments which contain upper cervical inspiratory neurons.

Interplay Between the Inspiratory and Postural Functions of the Human Parasternal Intercostal Muscles

The parasternal intercostal muscles are obligatory inspiratory muscles. To test the hypothesis that they are also involved in trunk rotation and to assess the effect of any postural role on inspiratory drive to the muscles, intramuscular electromyographic (EMG) recordings were made from the parasternal intercostals on the right side in six healthy subjects during resting breathing in a neutral posture (“neutral breaths”), during an isometric axial rotation effort of the trunk to the right (“ipsilateral rotation”) or left (“contralateral rotation”), and during resting breathing with the trunk rotated. The parasternal intercostals were commonly active during ipsilateral rotation but were consistently silent during contralateral rotation. In addition, with ipsilateral rotation, peak parasternal inspiratory activity was 201 ± 19% (mean ± SE) of the peak inspiratory activity in neutral breaths ( P < 0.001), and activity commenced earlier relative to the onset of inspiratory flow. These changes resulted from an increase in the discharge frequency of motor units (14.3 ± 0.3 vs. 11.0 ± 0.3 Hz; P < 0.001) and the recruitment of new motor units. The majority of units that discharged during ipsilateral rotation were also active in inspiration. However, with contralateral rotation, parasternal inspiratory activity was delayed relative to the onset of inspiratory flow, and peak activity was reduced to 72 ± 4% of that in neutral breaths ( P < 0.001). This decrease resulted from a decrease in the inspiratory discharge frequency of units (10.5 ± 0.2 vs. 12.0 ± 0.2 Hz; P < 0.001) and the derecruitment of units. These observations confirm that in addition to an inspiratory function, the parasternal intercostal muscles have a postural function. Furthermore the postural and inspiratory drives depolarize the same motoneurons, and the postural contraction of the muscles alters their output during inspiration in a direction-dependent manner.

Spinal circuitry and respiratory recovery following spinal cord injury

Numerous studies have demonstrated anatomical and functional neuroplasticity following spinal cord injury. One of the more notable examples is return of ipsilateral phrenic motoneuron and diaphragm activity which can be induced under terminal neurophysiological conditions after high cervical hemisection in the rat. More recently it has been shown that a protracted, spontaneous recovery also occurs in this model. While a candidate neural substrate has been identified for the former, the neuroanatomical basis underlying spontaneous recovery has not been explored. Demonstrations of spinal respiratory interneurons in other species suggest such cells may play a role; however, the presence of interneurons in the adult rat phrenic circuit - the primary animal model of respiratory plasticity - has not been extensively investigated. Emerging neuroanatomical and electrophysiological results raise the possibility of a more complex neural network underlying spontaneous recovery of phrenic function and compensatory respiratory neuroplasticity after C2 hemisection than has been previously considered.

Vestibular inputs to propriospinal interneurons in the feline C1-C2 spinal cord projecting to the C5-C6 ventral horn

The resting length of respiratory muscles must be altered during changes in posture in order to maintain stable ventilation. Prior studies showed that although the vestibular system contributes to these adjustments in respiratory muscle activity, the medullary respiratory groups receive little vestibular input. Additionally, previous transneuronal tracing studies demonstrated that propriospinal interneurons in the C(1)-C(2) spinal cord send projections to the ipsilateral diaphragm motor pool. The present study tested the hypothesis that C(1)-C(2) interneurons mediate vestibular influences on diaphragm activity. Recordings were made from 145 C(1)-C(2) neurons that could be antidromically activated from the ipsilateral C(5)-C(6 )ventral horn, 60 of which had spontaneous activity, during stimulation of vestibular receptors using electric current pulses or whole-body rotations in vertical planes. The firing of 19 of 31 spontaneously active neurons was modulated by vertical vestibular stimulation; the response vector orientations of many of these cells were closer to the pitch plane than the roll plane, and their response gains remained relatively constant across stimulus frequencies. Virtually all spontaneously active neurons responded robustly to electrical vestibular stimulation, and their response latencies were typically shorter than those for diaphragm motoneurons. Nonetheless, respiratory muscle responses to vestibular stimulation were still present after inactivation of the C(1)-C(2) cord using large injections of either muscimol or ibotenic acid. These data suggest that C(1)-C(2) propriospinal interneurons contribute to regulating posturally related responses of the diaphragm, although additional pathways are also involved in generating this activity.

Respiratory action of the intercostal muscles

The mechanical advantages of the external and internal intercostals depend partly on the orientation of the muscle but mostly on interspace number and the position of the muscle within each interspace. Thus the external intercostals in the dorsal portion of the rostral interspaces have a large inspiratory mechanical advantage, but this advantage decreases ventrally and caudally such that in the ventral portion of the caudal interspaces, it is reversed into an expiratory mechanical advantage. The internal interosseous intercostals in the caudal interspaces also have a large expiratory mechanical advantage, but this advantage decreases cranially and, for the upper interspaces, ventrally as well. The intercartilaginous portion of the internal intercostals (the so-called parasternal intercostals), therefore, has an inspiratory mechanical advantage, whereas the triangularis sterni has a large expiratory mechanical advantage. These rostrocaudal gradients result from the nonuniform coupling between rib displacement and lung expansion, and the dorsoventral gradients result from the three-dimensional configuration of the rib cage. Such topographic differences in mechanical advantage imply that the functions of the muscles during breathing are largely determined by the topographic distributions of neural drive. The distributions of inspiratory and expiratory activity among the muscles are strikingly similar to the distributions of inspiratory and expiratory mechanical advantages, respectively. As a result, the external intercostals and the parasternal intercostals have an inspiratory function during breathing, whereas the internal interosseous intercostals and the triangularis sterni have an expiratory function.

Effects of abdominal or cardiopulmonary sympathetic afferents on upper cervical inspiratory neurons

Responses of upper cervical inspiratory neurons (UCINs) to abdominal visceral or cardiopulmonary sympathetic stimulation were studied using extracellular recordings from 213 UCINs in 54 pentobarbital sodium-anesthetized and paralyzed rats. Phrenic nerve activity was used to assess inspiration. The UCINs discharging during inspiration only were mainly in the C(1) segment, whereas phase-spanning UCINs were mostly in the C(2) segment. Phase-spanning activity was typically retained after overventilation or vagotomy. When greater splanchnic nerve (GSN) or cardiopulmonary sympathetic afferent (CPSA) fibers were electrically stimulated, augmented UCIN activity was observed in 65% of cells responding to CPSA stimulation but in only 17% of cells responding to GSN. Response latencies were 10.7 +/- 0.5 and 20.6 +/- 1.5 (SE) ms, respectively. Many augmented responses to CPSA stimulation (64%) and all augmented responses to GSN stimulation were followed by suppression of UCIN discharge (biphasic response). Phrenic nerve activity was suppressed by both GSN and CPSA stimulation, but with shorter latency for the latter (29 +/- 0.7 vs. 14.0 +/- 0.7 ms). Excitation of UCINs using CPSA stimulation occurs more often and by a more direct pathway than for GSN input.

Morphological study of long axonal projections of ventral medullary inspiratory neurons in the rat

The aim of this study was to examine medullary and spinal axonal projections of inspiratory bulbospinal neurons of the rostral ventral respiratory group (VRG) in the rat. A direct visualization of long (9.8-33 mm) axonal branches, including those projecting to the contralateral side of the medulla oblongata and the spinal cord, was possible due to intracellular labeling with neurobiotin and long survival times (up to 22 h) after injections. Seven of the nine labeled neurons had bilateral descending axons, which were located in discrete regions of the spinal white matter; ipsilateral axons in the lateral and dorsolateral funiculus, contralateral in the ventral and ventromedial funiculus. The collaterals issued by these axons at the mid-cervical level formed close appositions with dendrites of phrenic motoneurons, which had also been labeled with neurobiotin. None of these collaterals crossed the midline. The significance of this finding is discussed in relation to the crossed-phrenic phenomenon. Additional spinal collaterals were identified in the C1 and T1 segments. Within the medulla, collaterals with multiple varicosities were identified in the lateral tegmental field and in the dorsomedial medulla (in the hypoglossal nucleus and in the nucleus of the solitary tract). These results demonstrate that inspiratory VRG neurons in the rat have some features which have not been previously described in the cat, including frequent bilateral spinal projection and projection to the nucleus of the solitary tract. In addition, this study shows that intracellular labeling with neurobiotin offers an effective way of tracing long axonal projections, supplementing results previously obtainable only with antidromic mapping, and providing morphological details which could not be observed in previous studies using labeling with horseradish peroxidase.

Evaluation of role of upper cervical inspiratory neurons in respiration, emesis and cough

Upper cervical (C1-3) inspiratory (UCI) propriospinal neurons project to spinal segments containing respiratory motoneurons, but their functional significance is unknown. Bilateral kainic acid injections into this cell column in 12 decerebrate cats (11 paralyzed and artificially ventilated) had no major effect on phrenic, intercostal, and abdominal nerve discharge or EMG activity during (fictive) respiration, vomiting and coughing. Thus, UCI neurons are unessential for activation of major respiratory muscles during these behaviors.

Short latency excitation of upper cervical respiratory neurons by vagal stimulation in the rat

Extracellular recordings were made from 29 respiration-phased neurons in the upper cervical spinal cord (C1-C3) in nine anesthetized rats while ipsilateral and contralateral vagi were stimulated via platinum hook electrodes. Neuronal responses to vagal stimulation were recorded using peristimulus histograms. An accumulation of spikes with an average latency of 4.0 +/- 0.8 (S.D.) ms occurred in 11 cells after ipsilateral stimulation. These results indicate that there are fibers in the vagus which oligosynaptically excite respiratory neurons in the upper cervical spinal cord.

Inhibition of inspiratory neurons of the nucleus retroambigualis by expiratory neurons of the Botzinger complex in the cat

The connection between expiratory neurons of the Botzinger Complex and contralateral inspiratory neurons of the nucleus retroambigualis was examined using the technique of spike-triggered averaging of intracellular potentials. Out of a total of 34 expiratory neurons found in the Botzinger Complex, 25 (73%) could be antidromically activated from the inspiratory region of the contralateral nucleus retroambigualis. The spike activities of 15 of these antidromically activated expiratory neurons were used as triggers for the averaging of the intracellular potentials recorded from 39 inspiratory neurons in the region of the contralateral nucleus retroambigualis. Unitary, inhibitory, postsynaptic potentials were observed in 11 of the 39 (28%) averages, from 6 of the 15 (40%) trigger neurons. It was concluded that these experiments demonstrate a monosynaptic inhibitory connection from expiratory neurons in the Botzinger Complex to inspiratory neurons in the contralateral nucleus retroambigualis.

Morphology of augmenting inspiratory neurons of the ventral respiratory group in the cat

The present study examined, in Nembutal-anesthetized and artificially ventilated cats, the morphologic properties of the inspiratory neurons of the ventral respiratory group (VRG). Horseradish peroxidase (HRP) was injected into 21 augmenting inspiratory or late inspiratory neurons with peak firing rates in the late inspiratory phase. The majority of the stained neurons were antidromically activated by stimulation of the cervical cord. Thirteen somata, located within or around the nucleus ambiguus (AMB), between 100 microns caudally and 2,000 microns rostrally to the obex, were stained. In ten cases, the stem axons issuing from the cells of origin coursed medially to cross the midline without giving off any axonal collaterals. Three neurons gave rise to axonal collaterals on the ipsilateral side, distributing boutons in the medullary reticular formation, in the vicinity of the AMB, hypoglossal nucleus, solitary tract, and dorsal motor nucleus of the vagus. In eight neurons, only the axons were labeled; in four of these, which were antidromically activated from the spinal cord, the stem axons crossed the midline 2,000-3,000 microns rostral to the obex and descended in the reticular formation around the AMB down to the cervical cord. They issued several axonal collaterals, distributing terminal boutons at the level of the caudal end of the retrofacial nucleus and about 1,000 microns rostral and caudal from the obex. Terminals were found mainly in and around the AMB, and a few were found in the vicinity of the dorsal motor nucleus of the vagus. The remaining four nonactivated axons distributed their terminal boutons widely in the reticular formation around the AMB. Thus, the augmenting inspiratory neurons of the VRG were shown to project not only to the spinal cord, but also to the VRG, hypoglossal nucleus, and dorsal motor nucleus of the vagus.

Intracellular recordings from upper cervical inspiratory neurons in the cat

Intracellular recordings were made from propriospinal, inspiratory neurons, at the lateral edge of lamina VII in the upper cervical cord of the cat. The membrane potentials were found to fluctuate with the central respiratory rhythm, as determined from a recording of the phrenic nerve discharge. Excitatory postsynaptic potentials occurred during the inspiratory phase, and inhibitory postsynaptic potentials were shown to occur in the expiratory phase by injecting chloride to reverse them. These recordings are the first demonstration that the upper cervical inspiratory neurons receive both excitation during inspiration and inhibition during expiration.