Short-term potentiation of breathing in humans

After-Discharge in the Upper Airway Muscle Genioglossus Following Brief Hypoxia

STUDY OBJECTIVES

Genioglossus after-discharge is thought to protect against pharyngeal collapse by minimising periods of low upper airway muscle activity. How genioglossus after-discharge occurs and which single motor units (SMUs) are responsible for the phenomenon are unknown. The aim of this study was to investigate genioglossal after-discharge.

METHODS

During wakefulness, after-discharge was elicited 8-12 times in healthy individuals with brief isocapnic hypoxia (45-60s of 10%O2 in N2) terminated by a single breath of 100% O2. Genioglossus SMUs were designated as firing solely, or at increased rate, during inspiration (Inspiratory phasic [IP] and inspiratory tonic [IT] respectively); solely, or at increased rate, during expiration (Expiratory phasic [EP] or expiratory tonic [ET] respectively) or firing constantly without respiratory modulation (Tonic). SMUs were quantified at baseline, the end of hypoxia, the hyperoxic breath and the following 8 normoxic breaths.

RESULTS

210 SMU's were identified in 17 participants. Genioglossus muscle activity was elevated above baseline for 7 breaths after hyperoxia (p<0.001), indicating a strong after-discharge effect. After-discharge occurred due to persistent firing of IP and IT units that were recruited during hypoxia, with minimal changes in ET, EP or Tonic SMUs. The firing frequency of units that were already active changed minimally during hypoxia or the afterdischarge period (P>0.05).

CONCLUSION

That genioglossal after-discharge is almost entirely due to persistent firing of previously silent inspiratory SMUs provides insight into the mechanisms responsible for the phenomenon and supports the hypothesis that the inspiratory and expiratory/tonic motor units within the muscle have idiosyncratic functions.

The effect of pedalling cadence on respiratory frequency: passive vs. active exercise of different intensities

PURPOSE

Pedalling cadence influences respiratory frequency (f_R) during exercise, with group III/IV muscle afferents possibly mediating its effect. However, it is unclear how exercise intensity affects the link between cadence and f_R. We aimed to test the hypothesis that the effect of cadence on f_R is moderated by exercise intensity, with interest in the underlying mechanisms.

METHODS

Ten male cyclists performed a preliminary ramp incremental test and three sinusoidal experimental tests on separate visits. The experimental tests consisted of 16 min of sinusoidal variations in cadence between 115 and 55 rpm (sinusoidal period of 4 min) performed during passive exercise (PE), moderate exercise (ME) and heavy exercise (HE). The amplitude (A) and phase lag (φ) of the dependent variables were calculated.

RESULTS

During PE, f_R changed in proportion to variations in cadence (r = 0.85, P < 0.001; A = 3.9 ± 1.4 breaths·min^-1; φ = - 5.3 ± 13.9 degrees). Conversely, the effect of cadence on f_R was reduced during ME (r = 0.73, P < 0.001; A = 2.6 ± 1.3 breaths·min^-1; φ = - 25.4 ± 26.3 degrees) and even more reduced during HE (r = 0.26, P < 0.001; A = 1.8 ± 1.0 breaths·min^-1; φ = - 70.1 ± 44.5 degrees). No entrainment was found in any of the sinusoidal tests.

CONCLUSION

The effect of pedalling cadence on f_R is moderated by exercise intensity-it decreases with the increase in work rate-and seems to be mediated primarily by group III/IV muscle afferents, at least during passive exercise.

Respiratory frequency and tidal volume during exercise: differential control and unbalanced interdependence

Differentiating between respiratory frequency (fR ) and tidal volume (VT ) may improve our understanding of exercise hyperpnoea because fR and VT seem to be regulated by different inputs. We designed a series of exercise manipulations to improve our understanding of how fR and VT are regulated during exercise. Twelve cyclists performed an incremental test and three randomized experimental sessions in separate visits. In two of the three experimental visits, participants performed a moderate-intensity sinusoidal test followed, after recovery, by a moderate-to-severe-intensity sinusoidal test. These two visits differed in the period of the sinusoid (2 min vs. 8 min). In the third experimental visit, participants performed a trapezoidal test where the workload was self-paced in order to match a predefined trapezoidal template of rating of perceived exertion (RPE). The results collectively reveal that fR changes more with RPE than with workload, gas exchange, VT or the amount of muscle activation. However, fR dissociates from RPE during moderate exercise. Both VT and minute ventilation ( V ˙ E ) showed a similar time course and a large correlation with V ˙ CO 2 in all the tests. Nevertheless, V ˙ CO 2 was associated more with V ˙ E than with VT because VT seems to adjust continuously on the basis of fR levels to match V ˙ E with V ˙ CO 2 . The present findings provide novel insight into the differential control of fR and VT - and their unbalanced interdependence - during exercise. The emerging conceptual framework is expected to guide future research on the mechanisms underlying the long-debated issue of exercise hyperpnoea.

Neural Network Reconfigurations: Changes of the Respiratory Network by Hypoxia as an Example

Neural networks, including the respiratory network, can undergo a reconfiguration process by just changing the number, the connectivity or the activity of their elements. Those elements can be either brain regions or neurons, which constitute the building blocks of macrocircuits and microcircuits, respectively. The reconfiguration processes can also involve changes in the number of connections and/or the strength between the elements of the network. These changes allow neural networks to acquire different topologies to perform a variety of functions or change their responses as a consequence of physiological or pathological conditions. Thus, neural networks are not hardwired entities, but they constitute flexible circuits that can be constantly reconfigured in response to a variety of stimuli. Here, we are going to review several examples of these processes with special emphasis on the reconfiguration of the respiratory rhythm generator in response to different patterns of hypoxia, which can lead to changes in respiratory patterns or lasting changes in frequency and/or amplitude.

Pharmacological modulation of hypoxia-induced respiratory neuroplasticity

Hypoxia elicits complex cell signaling mechanisms in the respiratory control system that can produce long-lasting changes in respiratory motor output. In this article, we review experimental approaches used to elucidate signaling pathways associated with hypoxia, and summarize current hypotheses regarding the intracellular signaling pathways evoked by intermittent exposure to hypoxia. We review data showing that pharmacological treatments can enhance neuroplastic responses to hypoxia. Original data are included to show that pharmacological modulation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) function can reveal a respiratory neuroplastic response to a single, brief hypoxic exposure in anesthetized mice. Coupling pharmacologic treatments with therapeutic hypoxia paradigms may have rehabilitative value following neurologic injury or during neuromuscular disease. Depending on prevailing conditions, pharmacologic treatments can enable hypoxia-induced expression of neuroplasticity and increased respiratory motor output, or potentially could synergistically interact with hypoxia to more robustly increase motor output.

Time Domains of the Hypoxic Ventilatory Response and Their Molecular Basis

Ventilatory responses to hypoxia vary widely depending on the pattern and length of hypoxic exposure. Acute, prolonged, or intermittent hypoxic episodes can increase or decrease breathing for seconds to years, both during the hypoxic stimulus, and also after its removal. These myriad effects are the result of a complicated web of molecular interactions that underlie plasticity in the respiratory control reflex circuits and ultimately control the physiology of breathing in hypoxia. Since the time domains of the physiological hypoxic ventilatory response (HVR) were identified, considerable research effort has gone toward elucidating the underlying molecular mechanisms that mediate these varied responses. This research has begun to describe complicated and plastic interactions in the relay circuits between the peripheral chemoreceptors and the ventilatory control circuits within the central nervous system. Intriguingly, many of these molecular pathways seem to share key components between the different time domains, suggesting that varied physiological HVRs are the result of specific modifications to overlapping pathways. This review highlights what has been discovered regarding the cell and molecular level control of the time domains of the HVR, and highlights key areas where further research is required. Understanding the molecular control of ventilation in hypoxia has important implications for basic physiology and is emerging as an important component of several clinical fields. © 2016 American Physiological Society. Compr Physiol 6:1345-1385, 2016.

Short-term potentiation in the control of pharyngeal muscles in obstructive apnea patients

STUDY OBJECTIVES

To determine if activation of the genioglossus (GG) muscle during obstructive apnea events involves short-term potentiation (STP) and is followed by sustained activation beyond the obstructive phase (after-discharge).

DESIGN

Physiological study.

SETTING

Sleep laboratory in a tertiary hospital.

PARTICIPANTS

Twenty-one patients with obstructive apnea.

INTERVENTIONS

Polysomnography on continuous positive airway pressure (CPAP) with measurement of genioglossus activity. Brief dial-downs of CPAP to induce obstructive events.

MEASUREMENTS AND RESULTS

Peak, phasic, and tonic genioglossus activities were measured breath-by-breath before, during, and following three-breath obstructions. Tonic but not phasic activity increased immediately following the first obstructed breath (4.9 ± 1.6 versus 3.6 ± 1.2 %GGMAX; P = 0.01) under conditions where stimuli to genioglossus activation were likely constant, strongly implicating STP in mediating recruitment of tonic activity. Both phasic and tonic activities declined slowly after relief of obstruction (after-discharge). Decay time constants were systematically shorter for phasic than for tonic activity (7.5 ± 3.8 versus 18.1 ± 8.4 sec; P < 0.001). Decay time-constant of peak activity correlated with tonic, but not phasic, recruitment. Cortical arousal near the end of obstruction resulted in a lower after-discharge (P < 0.01). Contribution of tonic activity to the increase in peak activity (6-65%Peak), as well as the decay constant (6-30 sec), varied considerably among patients.

CONCLUSIONS

Short-term potentiation contributes to recruitment of the genioglossus during obstructive episodes and results in sustained tonic activity beyond the obstructive phase, thereby potentially preventing recurrence of obstruction. Wide response differences among subjects suggest that this mechanism may contribute to severity of the disorder. The after-discharge is inhibited following cortical arousal, potentially explaining arousals' destabilizing effect.

Hypoxia triggers short term potentiation of phrenic motoneuron discharge after chronic cervical spinal cord injury

Repeated exposure to hypoxia can induce spinal neuroplasticity as well as respiratory and somatic motor recovery after spinal cord injury (SCI). The purpose of the present study was twofold: to define the capacity for a single bout of hypoxia to trigger short-term plasticity in phrenic output after cervical SCI and to determine the phrenic motoneuron (PhrMN) bursting and recruitment patterns underlying the response. Hypoxia-induced short term potentiation (STP) of phrenic motor output was quantified in anesthetized rats 11 weeks following lateral spinal cord hemisection at C2 (C2Hx). A 3-min hypoxic episode (12-14% O2) always triggered STP of inspiratory burst amplitude, the magnitude of which was greater in phrenic bursting ipsilateral vs. contralateral to C2Hx. We next determined if STP could be evoked in recruited (silent) PhrMNs ipsilateral to C2Hx. Individual PhrMN action potentials were recorded during and following hypoxia using a "single fiber" approach. STP of bursting activity did not occur in cells initiating bursting at inspiratory onset, but was robust in recruited PhrMNs as well as previously active cells initiating bursting later in the inspiratory effort. We conclude that following chronic C2Hx, a single bout of hypoxia triggers recruitment of PhrMNs in the ipsilateral spinal cord with bursting that persists beyond the hypoxic exposure. The results provide further support for the use of short bouts of hypoxia as a neurorehabilitative training modality following SCI.

Phrenic motoneuron discharge patterns during hypoxia-induced short-term potentiation in rats

Hypoxia-induced short-term potentiation (STP) of respiratory motor output is manifested by a progressive increase in activity after the acute hypoxic response and a gradual decrease in activity on termination of hypoxia. We hypothesized that STP would be differentially expressed between physiologically defined phrenic motoneurons (PhrMNs). Phrenic nerve "single fiber" recordings were used to characterize PhrMN discharge in anesthetized, vagotomized and ventilated rats. PhrMNs were classified as early (Early-I) or late inspiratory (Late-I) according to burst onset relative to the contralateral phrenic neurogram during normocapnic baseline conditions. During hypoxia (F(I)O(2) = 0.12-0.14, 3 min), both Early-I and Late-I PhrMNs abruptly increased discharge frequency. Both cell types also showed a progressive increase in frequency over the remainder of hypoxia. However, Early-I PhrMNs showed reduced overall discharge duration and total spikes/breath during hypoxia, whereas Late-I PhrMNs maintained constant discharge duration and therefore increased the number of spikes/breath. A population of previously inactive (i.e., silent) PhrMNs was recruited 48 +/- 8 s after hypoxia onset. These PhrMNs had a Late-I onset, and the majority (8/9) ceased bursting promptly on termination of hypoxia. In contrast, both Early-I and Late-I PhrMNs showed post-hypoxia STP as reflected by greater discharge frequencies and spikes/breath during the post-hypoxic period (P < 0.01 vs. baseline). We conclude that the expression of phrenic STP during hypoxia reflects increased activity in previously active Early-I and Late-I PhrMNs and recruitment of silent PhrMNs. post-hypoxia STP primarily reflects persistent increases in the discharge of PhrMNs, which were active before hypoxia.

Ventilatory responses to isocapnic and poikilocapnic hypoxia in humans

We examined the hypoxic ventilatory response (HVR) including breathing frequency (f(R)) and tidal volume (V(T)) responses during 20 min of step isocapnic (IH) and poikilocapnic (PH) hypoxia (45 Torr). We hypothesized an index related to [Formula: see text] (pHPR) may be more robust during PH. Peak HVR was suppressed during PH (P<0.001), and mediated by V(T) during PH and both V(T) and f(R) during IH. The relative magnitude of HVD remained similar between conditions indicating a suppressive role of hypocapnia in development of the HVR unrelated to the degree of subsequent HVD, implying a primarily O(2) dependant mechanism. Post-hypoxic frequency decline was observed following both IH (3.4+/-3.7 bpm, P<0.05) and PH (3.6+/-3.1 bpm, P<0.01), despite no f(R) response during exposure to PH. Use of pHPR improved the signal to noise ratio during PH, though failed to detect the peak ventilatory response, and therefore may not be appropriate when describing peak responses.

Specific carotid body chemostimulation is sufficient to elicit phrenic poststimulus frequency decline in a novel in situ dual-perfused rat preparation

Time-dependent ventilatory responses to hypoxic and hypercapnic challenges, such as posthypoxic frequency decline (PHxFD) and posthypercapnic frequency decline (PHcFD), could profoundly affect breathing stability. However, little is known about the mechanisms that mediate these phenomena. To determine the contribution of specific carotid body chemostimuli to PHxFD and PHcFD, we developed a novel in situ arterially perfused, vagotomized, decerebrate rat preparation in which central and peripheral chemoreceptors are perfused separately (i.e., a nonanesthetized in situ dual perfused preparation). We confirmed that 1) the perfusion of central and peripheral chemoreceptor compartments was independent by applying specific carotid body hypoxia and hypercapnia before and after carotid sinus nerve transection, 2) the PCO(2) chemoresponse of the dual perfused preparation was similar to other decerebrate preparations, and 3) the phrenic output was stable enough to allow investigation of time-dependent phenomena. We then applied four 5-min bouts (separated by 5 min) of specific carotid body hypoxia (40 Torr PO(2) and 40 Torr PCO(2)) or hypercapnia (100 Torr PO(2) and 60 Torr PCO(2)) while holding the brain stem PO(2) and PCO(2) constant. We report the novel finding that specific carotid body chemostimuli were sufficient to elicit several phrenic time-dependent phenomena in the rat. Hypoxic challenges elicited PHxFD that increased with bout, leading to progressive augmentation of the phrenic response. Conversely, hypercapnia elicited short-term depression and PHcFD, neither of which was bout dependent. These results, placed in the context of previous findings, suggest multiple physiological mechanisms are responsible for PHxFD and PHcFD, a redundancy that may illustrate that these phenomena have significant adaptive advantages.

Cardio-respiratory measures following isocapnic voluntary hyperventilation

In some individuals, breathing is greater than at rest following voluntary hyperventilation. Most previous investigations have employed short hyperventilation periods; here we examine the time course of cardio-respiratory measures before, during, and after a 5-min voluntary hyperventilation, maintaining isocapnia throughout. We examined the possible co-involvement of the cardiovascular system; hypothesising that post-hyperventilation hyperpnoea results from an increase in autonomic arousal. In four subjects (two males, two females) of 18 (nine males, nine females) we observed a post-hyperventilation hyperpnoea, characterised by a slow decline of ventilation toward resting levels with a time constant of 109.0 +/- 16.1s. By contrast, heart rate, and systolic and diastolic blood pressure were unchanged from rest during and after voluntary hyperventilation for all subjects. We concluded that males and females were equally likely to exhibit post-hyperventilation hyperpnoea, and suggest that they may be characterised by an increased resting heart rate and the choice of breathing frequency to increase ventilation during the voluntary hyperventilation. We further concluded that post-hyperventilation hyperpnoea is rare, but when present is a strong and lasting phenomenon, and that it is not the result of an increased autonomic arousal.

Ventilatory dynamics and control of blood gases after maximal exercise in the Thoroughbred horse

Despite enormous rates of minute ventilation (V̇e) in the galloping Thoroughbred (TB) horse, the energetic demands of exercise conspire to raise arterial Pco2(i.e., induce hypercapnia). If locomotory-respiratory coupling (LRC) is an obligatory facilitator of high V̇e in the horse such as those found during galloping (Bramble and Carrier. Science 219: 251–256, 1983), V̇e should drop precipitously when LRC ceases at the galloptrot transition, thus exacerbating the hypercapnia. TB horses ( n = 5) were run to volitional fatigue on a motor-driven treadmill (1 m/s increments; 14–15 m/s) to study the dynamic control of breath-by-breath V̇e, O2uptake, and CO2output at the transition from maximal exercise to active recovery (i.e., trotting at 3 m/s for 800 m). At the transition from the gallop to the trot, V̇e did not drop instantaneously. Rather, V̇e remained at the peak exercising levels (1,391 ± 88 l/min) for ∼13 s via the combination of an increased tidal volume (12.6 ± 1.2 liters at gallop; 13.9 ± 1.6 liters over 13 s of trotting recovery; P < 0.05) and a reduced breathing frequency [113.8 ± 5.2 breaths/min (at gallop); 97.7 ± 5.9 breaths/min over 13 s of trotting recovery ( P < 0.05)]. Subsequently, V̇e declined in a biphasic fashion with a slower mean response time (85.4 ± 9.0 s) than that of the monoexponential decline of CO2output (39.9 ± 4.7 s; P < 0.05), which rapidly reversed the postexercise arterial hypercapnia (arterial Pco2at gallop: 52.8 ± 3.2 Torr; at 2 min of recovery: 25.0 ± 1.4 Torr; P < 0.05). We conclude that LRC is not a prerequisite for achievement of V̇e commensurate with maximal exercise or the pronounced hyperventilation during recovery.

Effects of theophylline on ventilatory poststimulus potentiation in patients with brain damage

Patients with brain damage, in contrast to normal subjects, exhibit a significant ventilatory undershoot when brief hypocapnic hypoxia is terminated abruptly by hyperoxia. This has been attributed to an impairment of activation of short-term potentiation, a brain stem mechanism promoting breathing stability. We hypothesized that in these patients theophylline, a drug that stabilizes breathing, may affect short-term potentiation. Eight stable patients with brain damage and 10 normal adults were studied. Activation of short-term potentiation was examined by brief exposure to hypoxia followed by hyperoxia after pretreatment with placebo or theophylline. Both in patients and normal subjects at the end of hypoxia ventilation increased to a similar magnitude with and without theophylline. In normal subjects independent of pretreatment, when hypoxia was terminated abruptly by hyperoxia, ventilation declined slowly to baseline without an undershoot, indicating activation of short-term potentiation. In patients with placebo, ventilation upon switching to hyperoxia exhibited a significant undershoot. This undershoot was significantly attenuated by theophylline, although compared with normal subjects, a slight hypoventilation was observed. We conclude that in patients with brain damage, theophylline largely prevents the hyperoxic drop of ventilation, presumably by affecting the activation of short-term potentiation. This may underlie the beneficial effect of theophylline on breathing stability.

Associative conditioning of the exercise ventilatory response in humans

Repeated hypercapnic exercise augmented the ventilatory response to subsequent trials of exercise alone in running goats and in humans performing arm exercise, suggesting a form of associative conditioning or 'long-term modulation' had taken place. These studies did not include 'control' single stimulus conditioning paradigms. This study demonstrated that ten repeated trials of familiar leg bicycling exercise with dead-space induced hypercapnia also elicited similar significant increases in inspired ventilation (+ 22%; P < 0.009) and tidal volume (VT; + 255 +/- 73 ml(BTPS); mean +/- S.E.M.; P = 0.004) within the first 20 sec of subsequent exercise only trials. Long-term modulation of the early ventilatory response to cycling was not fully replicated by ten trials of 'control' paradigms involving either repeated exercise alone or resting dead space alone. This study thus demonstrated that long term modulation of the early ventilatory response exercise was due to an explicit effect of associative conditioning and not simply sensitisation to repeated trials of a single stimulus.

Effects of neural drives on breathing in the awake state in humans

We have developed a mathematical model of the regulation of ventilation that successfully simulates breathing in the awake as well as in sleeping states. In previous models, which were used to simulate Cheyne-Stokes breathing and respiration during sleep, the controller was only responsive to chemical stimuli, and allowed no ventilation at sub-normal carbon dioxide levels. The current model includes several new features. The chemical controller responds continuously to changes in P(CO(2)) with a lower sensitivity during hypocapnia than in the hypercapnic ranges. Hypoxia interacts multiplicatively with P(CO(2)) over the entire range of activity. The controller in the current model, besides the chemical drive, includes also a neural component. This neural drive increases and decreases as the level of alertness changes, and adds or subtracts from ventilation levels demanded by the chemical controller. The model also includes the effects of post-stimulus potentiation (PSP) and hypoxic ventilatory depression (HVD). While PSP eliminates apneas after a disturbance and also dampens the subsequent dynamics of the respiration, it is not a major factor in the damping of the response. Another finding is that HVD is destabilizing. The model is the first to reproduce results reported in conscious humans after hyperventilation and after acute and longer-term hypoxia. It also reproduces the effects of NREM sleep.

Effect of endotoxin on ventilation and breath variability: role of cyclooxygenase pathway

To evaluate the effects of endotoxemia on respiratory controller function, 12 subjects were randomized to receive endotoxin or saline; six also received ibuprofen, a cyclooxygenase inhibitor, and six received placebo. Administration of endotoxin produced fever, increased respiratory frequency, decreased inspiratory time, and widened alveolar-arterial oxygen tension gradient (all p < or = 0.001); these responses were blocked by ibuprofen. Independent of ibuprofen, endotoxin produced dyspnea, and it increased fractional inspiratory time, minute ventilation, and mean inspiratory flow (all p < or = 0.025). Endotoxin altered the autocorrelative behavior of respiratory frequency by increasing its autocorrelation coefficient at a lag of one breath, the number of breath lags with significant serial correlations, and its correlated fraction (all p < 0.05); these responses were blocked by ibuprofen. Changes in correlated behavior of respiratory frequency were related to changes in arterial carbon dioxide tension (r = 0.86; p < 0.03). Endotoxin decreased the oscillatory fraction of inspiratory time in both the placebo (p < 0.05) and ibuprofen groups (p = 0.06). In conclusion, endotoxin produced increases in respiratory motor output and dyspnea independent of fever and symptoms, and it curtailed the freedom to vary respiratory timing-a response that appears to be mediated by the cyclooxygenase pathway.

An integrated model of the human ventilatory control system: the response to hypoxia

The mathematical model of the respiratory control system described in a previous companion paper is used to analyse the ventilatory response to hypoxic stimuli. Simulation of long-lasting isocapnic hypoxia at normal alveolar PCO2 (40 mmHg=5.33 kPa) shows the occurrence of a biphasic response, characterized by an initial peak and a subsequent hypoxic ventilatory decline (HVD). The latter is about as great as 2/3 of the initial peak and can be mainly ascribed to prolonged neural hypoxia. If isocapnic hypoxia is performed during hypercapnia (PACO2=48 mmHg =6.4 kPa), the ventilatory response is stronger and HVD is minimal (about 1/10-1/5 of the initial peak). During poikilocapnic hypoxia, ventilation exhibits smaller changes compared with the isocapnic case, with a rapid return toward baseline within a few minutes. Moreover, a significant undershoot occurs at the termination of the hypoxic period. This undershoot may lead to apnea and to a transient destabilization of the control system if the peripheral chemoreflex gain and time delay are twofold greater than basal.

An integrated model of the human ventilatory control system: the response to hypercapnia

This work presents a mathematical model of the human respiratory control system, based on physiological knowledge. It includes three compartments for gas storage and exchange (lungs, brain tissue and other body tissues), and various kinds of feedback mechanisms. These comprehend peripheral chemoreceptors in the carotid body, central chemoreceptors in the medulla and a central ventilatory depression. The latter acts by reducing the response of the central neural system to the afferent peripheral chemoreceptor activity during prolonged hypoxia of the brain tissue. Furthermore, the model considers local blood flow adjustments in response to O2 and CO2 arterial pressure changes. In this study, the model has been validated by simulating the response to square changes in alveolar PCO2, performed at different constant levels of alveolar PO2. A good agreement with data reported in the literature has been checked. Subsequently, a sensitivity analysis on the role of the main feedback mechanisms on ventilation response to CO2 has been performed. The results suggest that the ventilatory response to CO2 challenges during hyperoxia can be almost completely ascribed to the central chemoreflex, while, during normoxia, the peripheral chemoreceptors provide a modest contribution too. By contrast, the response to hypercapnic stimuli during hypoxia involves a complex superimposition among different factors with disparate dynamics. Hence, results suggest that the ventilatory response to hypercapnia during hypoxia is more complex than that provided by simple empirical models, and that discrimination between the central and peripheral components based on time constants may be misleading.

Time domains of the hypoxic ventilatory response in awake ducks: episodic and continuous hypoxia

Time-dependent ventilatory responses to episodic and continuous isocapnic hypoxia were measured in unidirectionally ventilated, awake ducks. Three protocols were used: (1) ten 3-min episodes of moderate hypoxia (10% O(2)) with 5-min normoxic intervals; (2) three 3-min episodes of severe hypoxia (8% O(2)) with 5-min normoxic intervals; and (3) 30-min of continuous moderate hypoxia. Ventilation (V(I)) increased immediately within a hypoxic episode (acute response), followed by a further slow rise in V(I) (short-term potentiation). The peak V(T) response increased from the first to second moderate hypoxic episode (progressive augmentation), but was unchanged thereafter. During normoxic intervals, V(I) increased progressively (56% following the tenth episode; long term facilitation). Time-dependent changes were not observed during or following 30-min of continuous hypoxia. Although several time-dependent ventilatory responses to episodic hypoxia are observed in awake ducks, they are relatively small and biased towards facilitation versus inhibitory mechanisms.

Influence of continuous speaking on ventilation

This study was conducted to explore the influence of speaking on ventilation. Twenty healthy young men were studied during periods of quiet breathing and prolonged speaking using noninvasive methods to measure chest wall surface motions and expired gas composition. Results indicated that all subjects ventilated more during speaking than during quiet breathing, usually by augmenting both tidal volume and breathing frequency. Ventilation did not change across repeated speaking trials. Quiet breathing was altered from its usual behavior following speaking, often for several minutes. Speaking-related increases in ventilation were found to be strongly correlated with lung volume expenditures per syllable. These findings have clinical implications for the respiratory care practitioner and the speech-language pathologist.

Plasticity of cardiorespiratory neural processing: classification and computational functions

Neural plasticity, or malleability of neuronal structure and function, is an important attribute of the mammalian forebrain and is generally thought to be a kernel of biological intelligence. In this review, we examine some reported manifestations of neural plasticity in the cardiorespiratory system and classify them into four functional categories, integral; differential; memory; and statistical-type plasticity. At the cellular and systems level the myriad forms of cardiorespiratory plasticity display emergent and self-organization properties, use- and disuse-dependent and pairing-specific properties, short-term and long-term potentiation or depression, as well as redundancy in series or parallel structures, convergent pathways or backup and fail-safe surrogate pathways. At the behavioral level, the cardiorespiratory system demonstrates the capability of associative and nonassociative learning, classical and operant conditioning as well as short-term and long-term memory. The remarkable similarity and consistency of the various types of plasticity exhibited at all levels of organization suggest that neural plasticity is integral to cardiorespiratory control and may subserve important physiological functions.

Neuronal mechanisms mediating the integration of respiratory responses to hypoxia

The activation of peripheral chemoreceptors by hypoxia or electrical stimulation of the carotid sinus nerve elicited a hypoxic respiratory response consisting of both stimulatory and subsequent or simultaneous inhibitory components (hypoxic respiratory stimulation and depression). Both components have different time domains of responses (time-dependent response), providing an integrated respiratory response to hypoxia. This review has focused on the neuroanatomical and neurophysiological correlations responsible for these responses and their neuropharmacological mechanisms. Hypoxic respiratory depression is characterized by the initial activation of respiration followed by a progressive and gradual decline in ventilation during prolonged and/or severe hypoxic exposure (biphasic response). The responsible mechanisms for the depression are located within the central nervous system and may be dependent upon activity from peripheral chemoreceptor. Two underlying mechanisms contributing to the depression have been advocated. (1) Change in synaptic transmission: Within the neuronal network controlling the hypoxic respiratory response, hypoxia might induce the enhancement of inhibitory neurotransmission (modulation), disfacilitation of excitatory neruotransmission or both. (2) Change in the membrane property of respiratory neurons: Hypoxia might suppress the membrane excitability of respiratory neurons composing the hypoxic respiratory response via modulating ion channels, leading to hyperpolarization or depolarization blocking of the neurons. However, the quantitative aspects of Pao(2) (degree and duration of hypoxic exposure) to induce these changes and the susceptibility of both mechanisms to the Pao(2) level have not yet been clearly elucidated.

Short-term potentiation of carotid chemoreflex: an NMDAR-dependent neural integrator

Repetitive stimulation of the carotid sinus nerve (CSN) elicits a short-term potentiation (STP) of the reflex response in respiratory motor output in mammals. The input-output transformation approximates a leaky integrator with a time constant of several seconds. Here, we showed that STP induced by CSN stimulation in rats was manifested in the reflex response in the amplitude of rhythmic phrenic nerve activity as well as its duration. Moreover, pharmacological blockade of NMDA receptors (NMDAR) resulted in marked increases in the time constants of the equivalent neural integrator in both the STP induction phase (by 10- to 20-fold) and recovery phase (by 1- to 5-fold). Thus, NMDAR serves as a molecular switch that facilitates the integrative processing of CSN inputs by STP.

Short-term potentiation of ventilation after different levels of hypoxia

Short-term potentiation of ventilation (VSTP) may be observed in healthy subjects on sudden termination of an hypoxic stimulus. We hypothesized that the level of hypoxia preceding normoxia would modify the duration and magnitude of the ensuing ventilatory decay. Ten healthy adults were studied on two different occasions, during which they were randomly exposed to isocapnic 6 or 10% O2 for 60 s and then switched to an isocapnic normoxic gas mixture. Both hypoxic gases induced significant ventilatory responses, and mean peak minute ventilation before the isocapnic normoxic switch was higher in 6% O2 (P < 0.001). The fast time constant of the two-exponential equation representing the best fit for ventilatory decay was unaffected by the magnitude of the hypoxic stimulus. However, the slow time constant, which is considered to represent VSTP, was markedly prolonged in 6% compared with 10% O2 [106.7 +/- 11.3 vs. 38. 2 +/- 6.1 (SD) s, respectively; P < 0.0001]. This result indicates that VSTP is stimulus dependent. We conclude that the magnitude of hypoxia preceding a normoxic transient modifies VSTP characteristics. We speculate that the interdependence function of ventilatory stimulus and short-term potentiation is crucial for preservation of system stability during transitions from high to low ventilatory drives.

Effect of resistive loading on variational activity of breathing

To examine the effect of resistive loading on variational activity of breathing, we studied 18 healthy subjects breathing at rest and with inspiratory resistive loads of 3 and 6 cm H2O/L/s, applied randomly for 1 h each. Compared with resting breathing, a resistive load of 3 cm H2O/L/s decreased the total variational activity of expiratory time (TE) and minute ventilation (V I), whereas a load of 6 cm H2O/L/s increased the total variational activity of inspiratory time (TI). Compared with the load of 3 cm H2O/L/s, the load of 6 cm H2O/L/s increased total variational activity of tidal volume (VT), TI, TE, and V I. Partitioning of the total variational activity revealed that these alterations were due to changes in the random uncorrelated fraction. Compared with rest, both the resistive loads of 3 and 6 cm H2O/L/s increased the number of breath lags displaying significant serial correlations ("short-term memory") of TI. Compared with rest, the load of 3 cm H2O/L/s increased the autocorrelation coefficient at a lag of one breath for VT and the load of 6 cm H2O/L/s increased the correlated fraction of variational activity of VT. Thus, three measures of correlated behavior-autocorrelation coefficient at a lag of 1 breath, "short-term memory," and the correlated fraction of total variational activity- increased with loading. In conclusion, resistive loading changed total variational activity according to the size of the load: the random fraction decreased with the smaller load but increased with the larger load; in contrast, correlated behavior increased with both loads. The different behaviors of random and correlated variability with loading may reflect different physiologic influences on respiratory control.

Time domains of the hypoxic ventilatory response

The ventilatory response to hypoxia depends on the pattern and intensity of hypoxic exposure and involves several physiological mechanisms. These mechanisms differ in their effect (facilitation or depression) on different components of ventilation (tidal volume and frequency) and in their time course (seconds to years). Some mechanisms last long enough to affect future ventilatory responses to hypoxia, indicating 'memory' or functional plasticity in the ventilatory control system. A standard terminology is proposed to describe the different time domains of the hypoxic ventilatory response (HVR) and to promote integration of results from different experimental preparations and laboratories. In general, the neurophysiological and neurochemical basis for short time domains of the HVR (seconds and minutes) are understood better than longer time domains (days to years), primarily because short time domains are studied in the laboratory more easily. Understanding the mechanisms for different time domains of the HVR has important implications for both basic and clinical science.

Hypoxic ventilatory response and breathlessness following hypocapnic and isocapnic hyperventilation

STUDY OBJECTIVES

To investigate the etiology of posthyperventilation (post-HV) hypoxemia following voluntary hyperventilation (VHV), we examined the effects of hypocapnic (hypo-CO2) and isocapnic (iso-CO2) VHV on the hypoxic ventilatory response (O2-response) and on the sensation of breathlessness during the O2-response.

METHODS

O2-responses and visual analog scale (VAS) scores for estimating breathlessness in 10 normal subjects during the O2-response under iso-CO2 conditions and under hypo-CO2 conditions immediately following voluntary maximal HV of 3 min duration were examined.

RESULTS

Although there was no significant difference in the post-HV ventilation levels following hypo-CO2 vs iso-CO2 VHV, the VAS scores at the start of the O2-response following hypo-CO2 VHV (30.2+/-24.2 mm) were significantly higher (p<0.05) than the VAS scores at the start of the O2-response following iso-CO2 VHV (13.7+/-8.4 mm). However, VHV did not have a significant effect on the O2-response at 2 min after the VHV when the arterial O2 saturation (SaO2) was below 90%. The nonsteady-state hypo-CO2 induced by VHV greatly attenuated the O2-response below 90% SaO2 and VAS scores at 70% SaO2.

CONCLUSIONS

Elevated VAS scores immediately following the hypo-CO2 VHV, which might be independent of actual breathing levels, and the attenuation of the O2-response following the hypo-CO2 VHV were not due to input from lung and chest wall mechanoreceptors induced by the hyperpnea itself, but rather to the hypo-CO2 induced by hyperpnea.

Interaction of chemical and state effects on ventilation during sleep onset

Ventilation varies as a function of state, being higher during wakefulness (as indicated by alpha electroencephalogram activity) than during sleep (theta activity). A recent experiment observed a progressive increase in the magnitude of these state-related fluctuations in ventilation over the sleep-onset period (28). The aim of the present experiment was to test the hypothesis that this effect resulted from chemical (feedback-related) amplification of state effects on ventilation. A hyperoxic condition was used to eliminate peripheral chemoreceptor activity. It was hypothesized that hyperoxia would reduce the amplification of changes in ventilation associated with electroencephalogram state transitions. Ventilation was measured over the sleep-onset period under both hyperoxic and normoxic conditions in 10 young healthy male subjects. Sleep onsets were divided into three phases. Phase 1 corresponded to presleep wakefulness; and phases 2 and 3 corresponded to early and late sleep onset, respectively. The magnitudes of state-related changes in ventilation during phases 2 and 3, and under hyperoxic and normoxic conditions were compared using a phase by condition analysis of variance. Results revealed a significant phase by condition interaction, confirming that hyperoxia reduced the amplification of state-related changes in ventilation by selectively decreasing the magnitude of phase 3 state changes in ventilation. However, some degree of amplification was evident during hyperoxia, thus the results demonstrated that peripheral chemoreceptor activity contributed to the amplification of state-related changes in ventilation but that additional factors may also be involved.

Self-tuning Optimal Regulation of Respiratory Motor Output by Hebbian Covariance Learning

The respiratory motor system is a specialized musculoskeletal system that is controlled by a small assembly of neuronal clusters in the brainstem. Its prime function is to maintain CO(2), O(2), and pH homeostasis in arterial circulation through the motor act of breathing. A longstanding dilemma is that during muscular exercise homeostatic regulation occurs automatically without any apparent feedback or feedforward signals, whereas the homeostasis is readily abolished by exogenous chemical challenge. Recently, it has been proposed that these seemingly incongruous behaviors of the respiratory controller may be a manifestation of self-tuning adaptive control. This hypothesis is supported in part by recent discoveries of various memory systems in the brainstem controller including short- and long-term potentiation and depression of synaptic transmission as well as the dramatic abolishment of homeostatic regulation in mutant mice with targeted genetic disruption of the NMDA receptors. In this paper, we propose a model of self-tuning homeostatic regulation based upon a synaptic adaptation rule-Hebbian covariance learning rule-that has been suggested to underlie many forms of learning and memory in the higher brain. We show that such an adaptation rule may be a useful neuronal substrate for reinforcement learning in optimization tasks. The model demonstrates how spontaneous oscillations and/or random-like fluctuations of neural activity may be exploited by the controller to adaptively regulate and optimize motor output. Such a self-tuning neural control paradigm, which operates without the need for any internal model of the external environment, is generally applicable to a class of steady-state optimal regulation problems with infinite time horizon. An interesting implication of the present results is that brain intelligent control can occur at a subconscious level without the need for voluntary intervention from the higher brain. Copyright 1996 Elsevier Science Ltd.

Influence of hypoxic duration and posthypoxic inspired O2 concentration on short term potentiation of breathing in humans

1. Short term potentiation (STP) of breathing refers to respiratory activity at a higher level than expected just from the dynamics of the peripheral and central chemoreceptors. In humans STP is activated by hypoxic stimulation. 2. To investigate the effects of the duration of hypoxia and the posthypoxic inspired O2 concentration on STP, the ventilatory responses to 30 s and 1, 3 and 5 min of hypoxia (end-tidal PO2, P(ET.O2) approximately 6.5 kPa) followed by normoxia (P(ET.O2) approximately 14.5 kPa) and hyperoxia (P(ET.O2) approximately 70 kPa) were studied in ten healthy subjects. End-tidal PCO2 (P(ET.CO2)) was clamped during hypoxic and recovery periods at 5.7 kPa. 3. Steady-state ventilation (VE) was 13.7 +/- 0.6 l min-1 during normoxia and increased to 15.5 +/- 0.3 l min-1 during hyperoxia (P < 0.05) due to the reduced Haldane effect and some decrease in cerebral blood flow (CBF). 4. The mean responses following hypoxia reached normoxic baseline after 69, 54, 12 and 12 s when 30 s and 1, 3 and 5 min of hypoxia, respectively, were followed by normoxia. An undershoot of 10 and 20% below hyperoxic baseline was observed when 3 and 5 min of hypoxia, respectively, were followed by hyperoxia. Hyperoxic VE reached hyperoxic baseline after 9, 15, 12 and 9 s at the termination of 30 s and 1, 3 and 5 min of hypoxia, respectively. 5. Normoxic recovery from 30 s and 1 min of hypoxia displayed a fast and subsequent slow decrease towards normoxic baseline. The fast component was attributed to the loss of the hypoxic drive at the site of the peripheral chemoreceptors, and the slow component to the decay of the STP that had been activated centrally by the stimulus. A slow decrease at the termination of 30 s and 1 min of hypoxia by hyperoxia was not observed since this component was cancelled by the increase in ventilatory output due to the reduced Haldane effect and some decrease of CBF. 6. Decay of the STP was not apparent in the normoxic recovery from 3 and 5 min of hypoxia as a slow component since it cancelled against the slow ventilatory increase related to the increase of brain tissue PCO2 due to the reduction of CBF at the relief of hypoxia. The undershoot observed when hyperoxia followed 3 and 5 min of hypoxia reflects the stimulatory effects of hyperoxia on VE. 7. The manifestation of the STP as a slow ventilatory decrease depends on the duration of hypoxia and the subsequent inspired oxygen concentration. We argue that STP is not abolished by the central depressive effects of hypoxia, although the manifestation of the STP may be overridden or counteracted by other mechanisms.

Coupling of ventilation and gas exchange during transitions in work rate by humans

The dynamic responses of expired ventilation (VE) following transitions in work rate were studied during step increases and decreases, and during pseudorandom binary sequence (PRBS) changes in work rate. Six healthy men completed multiple repetitions of each test type under conditions of hypoxia (fractional inspired O2, FIO2 = 0.14), room air and hyperoxia (FIO2 = 0.70). Neither potentiation nor attenuation of the carotid chemoreceptors, with hypoxia or hyperoxia respectively, influenced the magnitude or duration of the phase 1 response at the onset of exercise. However, the off-transient phase 1 was smaller with hypoxia than normoxia or hyperoxia. The time course of phase 2 was faster in hypoxia and slower in hyperoxia, but there was symmetry between on- and off-responses. This was counter to predictions of asymmetry based on the short-term potentiation hypothesis. Tight coupling existed for breath-by-breath VE relative to CO2 output during PRBS exercise, especially in hypoxia (r2 = 0.40 +/- 0.08; 0.64 +/- 0.03; and 0.71 +/- 0.05 for hyperoxia; normoxia; and, hypoxia), but poorer coupling existed to O2 uptake, especially in hyperoxia (r2 = 0.09 +/- 0.04; 0.37 +/- 0.05; and 0.46 +/- 0.07). These data are consistent with neural factors in phase 1, and humoral mediation of phase 2 responses during dynamic exercise in healthy subjects.

Effect of hypoxic sensitivity on decay of respiratory short-term potentiation

In normal conscious humans, when a brief hypoxic ventilatory stimulus is followed immediately by breathing 100% O2, ventilation during hyperoxia gradually declines to baseline prehypoxic levels without an undershoot. During the decline, ventilation is greater than baseline in the absence of hypoxia and hypercapnia. This has been interpreted as evidence of decay of short-term potentiation (STP) or afterdischarge. It is not known whether the intensity of the stimulus that activates STP influences the time course of its decay. Therefore we studied STP decay in nine normal adults after administration of placebo (P) and almitrine (A) in a single-blind manner on 2 separate days. On each day, three runs consisting of 45 s of isocapnic hypoxia (end-tidal PO2 = 55 mm Hg) followed by 2 min of hyperoxia were conducted while ventilation (VI) was measured breath by breath. Baseline VT did not differ between A and P, but at the end of hypoxia, VI with A was 169 +/- 14% (SE) of baseline while VI with P was 132 +/- 7% of baseline (p < 0.05). Immediately after hyperoxia was instituted, VI fell abruptly, the fall being 36% of baseline for A and 15% for P. This probably represented the withdrawal of peripheral chemoreceptor input. Thereafter, VI declined slowly toward baseline, and the time course of this decline did not differ between P and A. Our results indicate that within the limits we studied, the increase of the intensity of the discharge of the peripheral chemoreceptors during hypoxia does not influence STP decay.

A review of the control of breathing during exercise

During the past 100 years many experimental investigations have been carried out in an attempt to determine the control mechanisms responsible for generating the respiratory responses observed during incremental and constant-load exercise tests. As a result of these investigations a number of different and contradictory control mechanisms have been proposed to be the sole mediators of exercise hyperpnea. However, it is now becoming evident that none of the proposed mechanisms are solely responsible for eliciting the exercise respiratory response. The present-day challenge appears to be one of synthesizing the proposed mechanisms, in order to determine the role that each mechanism has in controlling ventilation during exercise. This review, which has been divided into three primary sections, has been designed to meet this challenge. The aim of the first section is to describe the changes in respiration that occur during constant-load and incremental exercise. The second section briefly introduces the reader to traditional and contemporary control mechanisms that might be responsible for eliciting at least a portion of the exercise ventilatory response during these types of exercise. The third section describes how the traditional and contemporary control mechanisms may interact in a complex fashion to produce the changes in breathing associated with constant-load exercise, and incorporates recent experimental evidence from our laboratory.

Long-term facilitation of inspiratory intercostal nerve activity following carotid sinus nerve stimulation in cats

1. Repeated carotid sinus nerve (CSN) stimulation evokes a serotonin-dependent long-term facilitation (LTF) of phrenic nerve activity in cats. To determine whether CSN stimulation-evoked LTF is a general property of spinal inspiratory motoneurones, phrenic and inspiratory internal intercostal (IIC) nerve activities were recorded in nine cats (eight anaesthetized; one decerebrate), which were vagotomized, paralysed, thoracotomized and ventilated with O2; airway CO2 was controlled by means of of a servo-respirator. Baseline conditions were established by setting the arterial CO2 pressure (Pa,CO2) at approximately 2 mmHg above the threshold for IIC activity. One CSN was stimulated (3 times threshold, 25 Hz, 0.5 ms duration) with five (2 min) trains, each separated by 5 min. 2. The peak integrated phrenic activity was elevated by 33% whereas IIC activity was elevated by 226% above baseline, 90 min post-stimulation (P < 0.05). The results were similar when expressed as a percentage of the maximal neural activities (elicited by combined hypercapnia and CSN stimulation), although differences between the nerves were less pronounced. The burst frequency was not change following stimulation. 3. In five additional cats that were pretreated with the serotonin receptor antagonist, methysergide maleate (0.5-1 mg kg-1, I.V.), the CO2 thresholds of the phrenic (12 mmHg) and IIC nerves (22 mmHg) were increased (P < 0.05), and LTF could not be elicited in either neurogram. 4. Successive CSN stimulation episodes evoked a previously undescribed phenomenon. Although the peak integrated phrenic activity was unchanged (90-95% of maximal), IIC activity increased progressively during successive stimulus episodes (66-90% of maximal; P < 0.05). However, after methysergide treatment, the initial stimulus-evoked phrenic response decreased to 58% of maximal and both neurograms exhibited progressive augmentation of the stimulus-evoked response. As stimulus-evoked augmentation does not require serotonin, it is independent of LTF. 5. We conclude that CSN stimulation-evoked LTF of IIC activity exceeds that of phrenic activity. Since LTF requires the neuromodulator serotonin and is expressed predominantly by changes in burst pattern formation versus rhythm generation, serotonin may exert a greater influence on IIC relative to phrenic respiratory motor output. A unique mechanism is described whereby successive CSN stimulus episodes cause progressively increasing responses in both neurograms.

Post-hyperventilation apnoea in conscious humans

1. In nine normal subjects, analysis was performed of the number, length and location of apnoeic pauses during 20 min of recovery following voluntary overbreathing (VHV). Four different rates of recovery of end-tidal PCO2 (PET,CO2), studied in randomized order, were induced by overbreathing to 15 or 25 mmHg, each for 3 or 6 min. Subjects breathed mildly hyperoxic gas mixtures (inspired PO2 approximately 250 mmHg) to and fro into an open circuit via a mouthpiece and pneumotachograph. 2. Apnoeic pauses rarely occurred immediately after the end of VHV but gradually increased in number and length. When averaged across all subjects and protocols, the largest pauses occurred 2.0 +/- 0.3 min (S.D.; range 1.6-2.4 min) after the end of VHV. Based on a definition of apnoea as expiratory time greater than 6 s, apnoeas occurred between mean times of 0.8 and 5.6 min after the end of VHV, the end of this period being associated with a mean PET,CO2 value of 36.4 mmHg, which was below the initial mean resting value of 39.8 mmHg. 3. Within this apnoeic period, 80% of experiments produced apnoeas of less than 10 s duration, 61% of between 10 and 20 s duration and 42% of between 20 and 30 s duration. Only one out of nine subjects consistently failed to show apnoeas. 4. The range of lengths of individual apnoeas and the number per minute were independent of the length and level of VHV and were not significantly different between the four protocols. 5. The number and length of apnoeas did not change in repeated runs in each subject. We were not able to confirm previous reports that apnoeas occurred more frequently in subjects familiar with the experiment. 6. These results reconciled previous studies showing either apnoea or hyperpnoea following voluntary overbreathing in conscious humans. They showed an initial period of heightened breathing lasting about a minute with few apnoeas, consistent with 'after-discharge'. Beyond that, apnoeas occurred as an 'all-or-nothing' phenomenon as long as PET,CO2 was on average less than 3.4 mmHg below resting PET,CO2. The occurrence and length of apnoeas was consistent in individual subjects with no evidence of a learning effect.

Respiratory short-term potentiation (after-discharge) in elderly humans

During a ventilatory stimulus, respiratory short-term potentiation (STP, after-discharge) develops, so that ventilation after the stimulus is greater than that before the stimulus. When the stimulus is withdrawn STP gradually decays, tending to prevent hypoventilation and therefore stabilizing breathing pattern. STP has been demonstrated in young humans after brief hypoxic stimuli. Since respiratory arrhythmias increase with age, we examined the decay of STP in normal elderly humans (mean age 62), comparing them with young normals (mean age 27). Resting subjects were exposed to 35-50 sec hypoxia (end-tidal PO2 = 55 Torr) followed by hyperoxia and breathing analyzed during the hyperoxic period, when the subjects were also hypocapnic. With hypoxia, ventilation increased to 152% of control in both the older and younger subjects while end-tidal CO2 fell to 92.0% of control in the older subjects and 94.7% of control in the younger. In both groups the hypoxic increase in ventilation was almost entirely due to an increase of tidal volume. During hyperoxia, ventilation and tidal volume declined over 20-25 sec to control, pre-hypoxic levels, without an apparent undershoot, and there were no consistent differences between the older and younger subjects. Prolonging the hypoxic exposure to 90 sec had no influence on STP in the older subjects. We conclude that neither age nor prolonging the hypoxic stimulus from 50 to 90 sec influenced STP.

Effects of memory from vagal feedback on short-term potentiation of ventilation in conscious dogs

1. We assessed short-term potentiation of ventilation in response to brief systemic normocapnic hypoxaemia in conscious dogs. Four recumbent dogs were exposed to Pa, O2 35-55 mmHg with Pa, CO2 maintained normocapnic for forty to fifty seconds and then abruptly returned to normoxia. Minute ventilation (VI) increased 4- to 5-fold during hypoxia due to both increased tidal volume (VT) and frequency (f). Several trials of hypoxic exposure with normoxic restoration were conducted with animals intact and following bilateral cold blockade of the cervical vagus nerves sufficient to block completely the Hering-Breuer reflex. 2. In the vagally intact dog, when normoxia was restored immediately following normocapnic hypoxia (PET, O2 = 40 Torr), expiratory time (TE) was prolonged to 190 +/- 68% of control (mean +/- S.E.M., range 53-350%) on the second or third breath and then returned slowly to control values on subsequent breaths. The prolongation of TE following removal of the hypoxic stimulus was positively correlated with the magnitude of the peak VT reached during hypoxic exposure. However, VT and VI remained significantly greater than control over a twenty second or four-breath period following hypoxia. 3. In the vagally blocked dog, no prolongation of TE was observed following isocapnic hypoxia; nor was TE following hypoxia correlated with the magnitude of the VT during hypoxia. The time constants of decay of VI, VT and f back to control, following hypoxia averaged 16, 19 and 9 s, respectively. 4. We conclude that short-term potentiation of ventilatory output following peripheral chemoreceptor hypoxic stimulation does exist in the awake dog, but the stimulatory after-effect is masked and TE is prolonged by a 'memory' of inhibitory vagal feedback. The magnitude of this inhibitory after-effect on TE prolongation increases in proportion to the increase in tidal volume achieved during the hypoxaemia. 5. This inhibitory effect of vagal memory may contribute to instability of breathing pattern and apnoea following transient disturbances in ventilatory output.