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Neural respiratory drive and breathlessness in COPD
Abstract
The aim of this study was to test the hypothesis that neural respiratory drive, measured using diaphragm electromyogram (EMG di ) activity expressed as a percentage of maximum (EMG di%max ), is closely related to breathlessness in chronic obstructive pulmonary disease. We also investigated whether neuroventilatory uncoupling contributes significantly to breathlessness intensity over an awareness of levels of neural respiratory drive alone. EMGdi and ventilation were measured continuously during incremental cycle and treadmill exercise in 12 chronic obstructive pulmonary disease patients (forced expiratory volume in 1 s± sd was 38.7±14.5 % pred). EMG di was expressed both as EMG di%max and relative to tidal volume expressed as a percentage of predicted vital capacity to quantify neuroventilatory uncoupling. EMG di%max was closely related to Borg breathlessness in both cycle (r=0.98, p=0.0001) and treadmill exercise (r=0.94, p=0.005), this relationship being similar to that between neuroventilatory uncoupling and breathlessness (cycling r=0.94, p=0.005; treadmill r=0.91, p=0.01). The relationship between breathlessness and ventilation was poor when expansion of tidal volume became limited. In chronic obstructive pulmonary disease the intensity of exertional breathlessness is closely related to EMG di%max . These data suggest that breathlessness in chronic obstructive pulmonary disease can be largely explained by an awareness of levels of neural respiratory drive, rather than the degree of neuroventilatory uncoupling. EMG di%max could provide a useful physiological biomarker for breathlessness in chronic obstructive pulmonary disease.
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“It is postulated that the amplitude of central neural drive (originating from motor cortical and medullary centers in the brain) to the respiratory muscles is sensed via neural inter-connections (i.e., central corollary discharge) between cortical motor and medullary centers in the brain and the somato-sensory cortex [75,77].”
From Lung hyperinflation in COPD: applying physiology to clinical practice (2015) · cites this paper as [77]
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Diaphragm Activation during Exercise in Chronic Obstructive Pulmonary Disease
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Cited by
Lung hyperinflation in COPD: applying physiology to clinical practice
O’Donnell, D. E., Webb, K. A., & Neder, J. A. (2015) · COPD Research and Practice · doi:10.1186/s40749-015-0008-8 · Cited by 93
Breathlessness and the brain: the role of expectation
Marlow, L. L., Faull, O. K., Finnegan, S. L., & Pattinson, K. T. S. (2019) · Current Opinion in Supportive & Palliative Care · doi:10.1097/spc.0000000000000441 · Cited by 77
Lozano-García, M., Sarlabous, L., Moxham, J., Rafferty, G. F., Torres, A., Jané, R., & Jolley, C. J. (2018) · Scientific Reports · doi:10.1038/s41598-018-35024-z · Cited by 32
Self-citationExercise‐induced dynamic hyperinflation in chronic obstructive pulmonary disease
D'Cruz, R. F., Wilkins, D., & Jolley, C. J. (2026) · Experimental Physiology · doi:10.1113/ep091459 · Cited by 3
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Metadata
- Authors
- Jolley, C. J., Luo, Y. M., Steier, J., Rafferty, G. F., Polkey, M. I., & Moxham, J.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2014-10-16
- Volume
- 45
- Issue
- 2
- Pages
- 355-364
- ISSN
- 0903-1936
- 1399-3003
- Cited by
- 134
- References
- 5
- Language
- en
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