Activating effect of nasal air flow on epileptic electrographic abnormalities in the human EEG. Evidence for the reflect origin of the phenomenon

Deep nasal breathing [with the mouth closed] activates [to a certain extent selectively], in the human EEG, epileptic abnormalities of diencephalotemporal origin [Servít et al. 1977]. This activating effect could be suppressed by local anaesthesia of the mucosa membrane in the superior nasal meatus. The same abnormalities could be elicited or activated by air insufflation into the upper nasal cavity, without pulmonary hyperventilation. These results speak in favour of the assumption that a neural [reflex] mechanism of the activating effect of nasal hyperventilation is involved, with a reflexogenic area in the superior nasal meatus.     

Influence of nasal airflow temperature and pressure on alae nasi electrical activity.

The influence of nasal airflow, temperature, and pressure on upper airway muscle electromyogram (EMG) was studied during steady-state exercise in five normal subjects. Alae nasi (AN) and genioglossus EMG activity was recorded together with nasal and oral airflows and pressures measured simultaneously by use of a partitioned face mask. At constant ventilations between 30 and 50 l/min, peak inspiratory AN activity during nasal breathing (7.2 +/- 1.4 arbitrary units) was greater than that during oral breathing (1.0 +/- 0.3 arbitrary units; P less than 0.005). In addition, the onset of AN EMG activity preceded inspiratory flow by 0.38 +/- 0.03 s during nasal breathing but by only 0.17 +/- 0.04 s during oral breathing (P less than 0.04). When the subject changed from nasal to oral breathing, both these differences were apparent on the first breath. However, peak AN activity during nasal breathing was uninfluenced by inspiration of hot saturated air (greater than 40 degrees C), by external inspiratory nasal resistance, or by changes in the expiratory route. The genioglossus activity did not differ between nasal and oral breathing (n = 2). Our findings do not support reflex control of AN activity sensitive to nasal flow, temperature, or surface pressure. We propose a centrally controlled feedforward modulation of phasic inspiratory AN activity linked with the tonic drive to the muscles determining upper airway breathing route.     

Mechanisms of control of alae nasi muscle activity.

Human upper airway dilator muscles are clearly influenced by chemical stimuli such as hypoxia and hypercapnia. Whether in humans there are upper airway receptors capable of modifying the activity of such muscles is unclear. We studied alae nasi electromyography (EMG) in normal men in an attempt to determine 1) whether increasing negative intraluminal pressure influences the activity of the alae nasi muscle, 2) whether nasal airway feedback mechanisms modify the activity of this muscle, and 3) if so, whether these receptor mechanisms are responding to mucosal temperature/pressure changes or to airway deformation. Alae nasi EMG was recorded in 10 normal men under the following conditions: 1) nasal breathing (all potential nasal receptors exposed), 2) oral breathing (nasal receptors not exposed), 3) nasal breathing with splints (airway deformation prevented), and 4) nasal breathing after nasal anesthesia (mucosal receptors anesthetized). In addition, in a separate group, the combined effects of anesthesia and nasal splints were assessed. Under each condition, EMG activity was monitored during basal breathing, progressive hypercapnia, and inspiratory resistive loading. Under all four conditions, both load and hypercapnia produced a significant increase in alae nasi EMG, with hypercapnia producing a similar increment in EMG regardless of nasal receptor exposure. On the other hand, loading produced greater increments in EMG during nasal than during oral breathing, with combined anesthesia plus splinting producing a load response similar to that observed during oral respiration. These observations suggest that nasal airway receptors have little effect on the alae nasi response to hypercapnia but appear to mediate the alae nasi response to loading or negative airway pressure.(ABSTRACT TRUNCATED AT 250 WORDS)     

The central effects of morphine on fetal breathing movements in the fetal sheep

The fetal respiratory and electrocortical effects of 0.6 microgram to 600 micrograms of morphine, administered into the lateral cerebral ventricle, have been studied in chronically catheterised, unanaesthetized fetal sheep at 115-135 days gestation. Morphine at 0.6 microgram had no effect on breathing movements or electrocorticographic activity, and at 6 micrograms induced a period of apnoea (43-122 min) but had no effect on electrocortical activity. Intravenous naloxone (2 mg bolus and infusion of 2 mg/kg/h for 2 h) to the fetus had no effect on this apnoea. Morphine at 60 micrograms induced an initial period of apnoea (30-65 min) followed by episodic but significantly deep breathing movements with no effect on electrocortical activity and at 600 micrograms induced an initial period of apnoea (22-95 min) which was followed by deep, irregular and continuous (126-302 min) breathing movements. During the apnoea electrocortical activity initially remained cyclic, but as apnoea progressed there was a gradual reduction in the voltage of the electrocorticogram to a low voltage state. Intravenous naloxone (2 mg bolus and infusion of 2 mg/kg/h for 2 h) reversed both the respiratory and electrocortical effects. The hyperventilation was also inhibited by hypoxia. Naloxone alone had no effect on fetal breathing activity.     

Control of extrathoracic airway dynamics

The ventilatory controlling factors associated with oral augmentation of nasal breathing were investigated in 25 (14 women, 11 men) healthy adults during an incrementally graded bicycle exercise test. Ventilatory variables were measured by separate oral and nasal pneumotachometers integrated with a valveless oral-nasal face mask and a flexible oral catheter. Inspired and expired breath length, nasal flows, nasal ventilation, transnasal pressures, nasal work of breathing, nasal powers, and nasal resistances were measured simultaneously on a breath-by-breath basis and averaged over the 30-s interval before oral augmentation. Subjects participated in a minimum of two separate tests, with statistical analysis focusing on the correlation obtained for nasal work of breathing (r = 0.870), nasal average power (r = 0.838), and average transnasal pressure (r = 0.819) during inspiration and for average nasal power (r = 0.801) during expiration indicates that these variables were the most reliable predictors of the oral augmentation of nasal breathing.     

Recovery of impaired respiratory activity in cats by thyroliberin analog (PR-546) devoid of hormonal properties

Synthetic analogue thyroliberin (PR-546) devoid of hormonal activity, recovered respiration in conditions of hyperventilation, two-sided vagotomy and hypoxia, caused by the 40-70% bleeding. PR-546 (in doses 100-500 micrograms/kg) intravenously injected was shown to abolish diagram activity decreased effect after hyperventilation. Injection of PR-546 to vagotomized cats in 1.5-2 h, increased breathing rate. The breathing activity resumed after long breaks in respiration as a result of peptide injection. The responses to analogue introductions is similar to the thyroliberin effect.     

Post-lesion yawning and thalamotomy site.

Yawning during hyperventilation occurred in certain patients post-thalamotomy. It was found that all of the lesions which elicited yawning (during the routine recording of electroencephalograms) were localized to the medial portion of the center-median nucleus. Yawning was noted to persist up to 3(1/2) years post surgery. Another group of patients who yawned when hyperventilated were patients with a history of a recent head injury who showed post-traumatic behavioral changes. Patients in both groups were young. There was no direct relationship between yawning and EEG abnormality. It was suggested that yawning during hyperventilation may serve as a sign of brain damage, especially at the brain stem level, in young patients.     

Separation of factors responsible for change in breathing pattern induced by instrumentation

Employment of mouthpiece and noseclips (MP + NC) has repeatedly been shown to increase tidal volume (VT), but its effect on respiratory frequency (f) and its subsets is controversial. The mechanisms accounting for this alteration in breathing pattern are poorly understood and may include stimulation of oral or nasal sensory receptors or alteration in the route of breathing. In this study we demonstrated that use of a MP + NC, compared with nonobtrusive measurement with a calibrated respiratory inductive plethysmograph, alters the majority of the volume and time indexes of breathing pattern, with increases in minute ventilation (P less than 0.01), VT (P less than 0.001), inspiratory time (TI, P less than 0.05), expiratory time (TE, P less than 0.05), mean inspiratory flow (P less than 0.05), and mean expiratory flow (P less than 0.05) and a decrease in f(P less than 0.05). Separating the potential mechanisms we found that when the respiratory route was not altered, independent oral stimulation (using an occluded MP) or nasal stimulation (by applying paper clips to the alae nasi) did not change the breathing pattern. In contrast, obligatory oral breathing without additional stimulation of the oral or nasal sensory receptors caused increases in VT (P less than 0.05), TI (P less than 0.05), and TE (P less than 0.01) and a fall in f(P less than 0.05). Heating and humidifying the inspired air did not prevent the alteration in breathing pattern with a MP. Thus change in the respiratory route is the major determinant of the alteration in breathing pattern with a MP + NC.(ABSTRACT TRUNCATED AT 250 WORDS)     

Behavior of the deeply inserted helices in diphtheria toxin T domain: helices 5, 8, and 9 interact strongly and promote pore formation, while helices 6/7 limit pore formation

Diphtheria toxin T domain aids the membrane translocation of diphtheria toxin A chain. When the isolated T domain is deeply membrane-inserted, helices TH 8-9 form a transmembrane hairpin, while helices TH 5-7 form a deeply inserted nontransmembrane structure. Blocking deep insertion of TH 8-9 blocks deep insertion of TH 5-7 ( Zhao, G., and London, E. ( 2005) Biochemistry 44, 4488- 4498 ). We now examine the effects of blocking the deep insertion of TH 5 and TH 6/7. An A282R/V283R dual substitution in TH 5 prevented its deep insertion, significantly decreased the deep insertion of TH 9, and to a lesser degree that of TH 6/7. Blocking deep insertion of TH 6/7 with a L307R mutation had no effect on the deep insertion of TH 5, similar to its previously characterized lack of effect on the deep insertion of TH 8-9. An I364K mutation in TH 9 blocked TH 8-9 deep insertion and greatly reduced pore formation by the T domain, consistent with the role of TH 8-9 in pore formation. The A282R/V283R mutations also reduced the extent of pore formation, but to a lesser degree, suggesting either that TH 5 is part of the pore or that interactions with TH 5 affect the ability of TH 8-9 to form pores. The L307R mutation enhanced the extent of pore formation, suggesting that deeply inserted TH 6/7 may act as a "cork" that partly blocks the pore. Combined, these results indicate that TH 5, 8, and 9 combine to form a deeply inserted scaffold of more strongly associated helices.     

LMR spectroscopy: a new sensitive method for on-line recording of nitric oxide in breath.

Laser magnetic resonance spectroscopy (LMRS) is a sensitive and isotope-selective technique for determining low concentrations of gaseous free radicals with high time resolution. We used this technique to analyze the nitric oxide (NO) concentration profile while simultaneously measuring the flow and expired volume during several single breathing cycles. Eight healthy, nonallergic volunteers were investigated. An initial NO peak was found in all breathing cycles before the NO concentration dropped to a relatively stable plateau in the late phase of expiration. The nasal NO peak was significantly higher than the oral NO peak. The nasal NO plateau was always higher than the oral NO plateau. The height of the initial nasal and oral NO peak rose with increasing duration of breath hold, whereas the late expiratory NO plateau changed only little for either the nasal or the oral breathing cycles. Our findings demonstrate, in line with other reports using other techniques, that the nose is the primary source for NO within the airways.     

Late EEG after-effects in humans following hyperventilation. I. A comparison between intero- and exteroceptive influences

Using a modification of the computer period analysis of the EEG (Aladjov and Daskalova 1987) we studied the late after-effects (until the 30th min) in human EEG (monopolar leads at F1, C3, P3 and 01) following two kinds of influences: a) short interoceptive one: 3 min hyperventilation (HV) and b) a series of 5 trains of visual light flashes (VS), presented in 5-7 min intervals. The changes in the ongoing EEG in the 2nd min after each VS and in intervals of 5 min after HV were compared with the values before the stimulation. VS did not elicit long-lasting EEG after-effects, which characterized the single interoceptive influence (HV) and consisted mainly of beta-2 (24-36 Hz) EEG activity increase in all studied cortical regions (Nikolov and Kisselkova 1988). Moreover, the exteroceptive stimulation (VS) had no essential influence on the late EEG after-effects after HV, when both kinds of stimulation were applied in the same experiment.     

Estimation of localization and dipole moment of alpha- and theta-rhythm sources by cluster analysis in healthy subjects and schizophrenics

In 12 healthy subjects and 9 schizophrenic patients in the background conditions (with eyes closed) EEG was recorded from 16 standard derivations (10-20 system) during 3 min. The record underwent the spectral analysis detecting alpha- and theta-frequency bands. After the preliminary narrow band filtration for the main frequencies the sources of the spontaneous rhythms were localized. The data on localization for all healthy subjects and patients were summarized. The K-means clustering was used for identification of the sources clusters which were revealed in occipital and parietal lobes and limbic cortex for alpha-rhythm and also in frontal, temporal and parietal regions, limbic cortex and hippocampus for theta-rhythm. In schizophrenic patients in comparison with healthy subjects there was revealed significant increase of the numbers of dipole sources of alpha-rhythm in the clusters localized in limbic cortex and hippocampus. For theta-rhythm there was significant increase of the dipole moment of the sources in the clusters localized in the temporal and frontal cortices and hippocampus in patients in comparison with the norm.     

Airway blood flow response to eucapnic dry air hyperventilation in sheep

Eucapnic hyperventilation, breathing dry air, produces a two- to fivefold increase in airway blood flow in the dog. To determine whether airway blood flow responds similarly in the sheep we studied 16 anesthetized sheep. Seven sheep (1-7) were subjected to two 30-min periods of eucapnic hyperventilation breathing 1) warm humid air [100% relative humidity (rh)] followed by 2) warm dry air [0% rh] at 40 breaths/min. To determine whether there was a dose-response effect on blood flow of increasing levels of hyperventilation of dry air, another nine sheep (8-16) were subjected to four 30-min periods of eucapnic hyperventilation breathing warm humid O2 followed by warm dry O2 at 20 or 40 breaths/min in random sequence. Five minutes before the end of each period of hyperventilation, hemodynamics, blood gases, and tracheal mucosal temperature were measured, and tracheal and bronchial blood flows were determined by injection of 15- or 50-micron-diam radiolabeled microspheres. After the last measurements had been made, all sheep were killed, and the lungs and trachea were removed for determination of blood flow to trachea, bronchi, and parenchyma. In sheep 1-7, warm dry air hyperventilation at 40 breaths/min produced an increase in blood flow to trachea (7.6 +/- 3.5 to 17.0 +/- 6.2 ml/min, P less than 0.05) and bronchi (9.0 +/- 5.4 to 18.2 +/- 8.2 ml/min, P less than 0.05) but not to the parenchyma. When blood flow was compared with the two ventilatory rates (sheep 8-16), tracheal blood flow increased (9.1 +/- 3.3 to 18.2 +/- 6.1 ml/min, P less than 0.05) at a rate of 40 breaths/min but not at 20 breaths/min.(ABSTRACT TRUNCATED AT 250 WORDS)     

Chaotic component of human high-frequency EEG in the state of quiet wakefulness

Chaotic component of human EEG oscillations in the high-frequency band (14.7-100 Hz) was investigated. EEG was recorded from four points in symmetrical frontal and occipital scalp areas. The results of the non-linear analysis of the high-frequency EEG indicate the existence of the deterministic chaotic component with a high attractor correlation dimension. It was significantly different from the respective values of the Gaussian noise filtered in the same frequency band. In the state of quiet wakefulness (eyes closed), the dimensions of chaotic components of the EEG in all derivations did not differ from each other. Analysis of correlation pairs between the ensembles of correlation dimensions of the high-frequency EEG revealed reliable patterns of significant connections between the neocortical areas with individual features in different subjects. When the functional state of the brain was changed by hyperventilation, both the values of the correlation dimensions and the structure of inter-area connection patterns changed. We believe that the nonlinear component of high-frequency EEG is a sensitive and local characteristic of the functional state of the human brain.     

Nasal contribution to breathing with exercise: effect of race and gender.

Because the nose acts as a filter to prevent penetration of toxic particles and gases to the lower respiratory tract, the route of breathing, oral vs. nasal, may be an important determinant of toxicant dose to the lungs. Using respiratory inductance plethysmography and a nasal mask fitted with flowmeter, we measured the nasal contribution to breathing at rest and during exercise (to 60% maximum workload) in healthy young adults (men/women = 11/11 and Caucasian/African-American = 11/11). We found that the nasal contribution to breathing is less during submaximal exercise in the Caucasians vs. African-Americans (e.g., at 60% maximum workload, mean nasal-to-total ventilation ratio = 0.40 +/- 0.21 and 0.65 +/- 0.24, respectively, P < 0.05). This difference is likely due to the African-Americans' ability to achieve higher maximal inspiratory flows through their nose than the Caucasians. Men also had a lesser nasal contribution to breathing during exercise compared with women. This is likely due to greater minute ventilations at any given percentage of maximum workload in men vs. women.     

Longitudinal distribution of chlorine absorption in human airways: a comparison to ozone absorption.

The bolus inhalation method was used to measure the fraction of inhaled chlorine (Cl(2)) and ozone (O(3)) absorbed during a single breath as a function of longitudinal position in the respiratory system of 10 healthy nonsmokers during oral and nasal breathing at respired flows of 150, 250, and 1,000 ml/s. At all experimental conditions, <5% of inspired Cl(2) penetrated beyond the upper airways and none reached the respiratory air spaces. On the other hand, larger penetrations of O(3) beyond the upper airways occurred as flow increased and during nasal than during oral breathing. In the extreme case of oral breathing at 1,000 ml/s, 35% of inhaled O(3) penetrated beyond the upper airways and approximately 10% reached the respiratory air spaces. Mass transfer theory indicated that the diffusion resistance of the tissue phase was negligible for Cl(2) but important for O(3). The gas phase resistances were the same for Cl(2) and O(3) and were directly correlated with the volume of the nose and mouth during nasal and oral breathing, respectively.     

Increased propensity for apnea in response to acute elevations in left atrial pressure during sleep in the dog.

Periodic breathing is commonly observed in chronic heart failure (CHF) when pulmonary capillary wedge pressure is abnormally high and there is usually concomitant tachypneic hyperventilation. We hypothesized that acute pulmonary hypertension at pressures encountered in CHF and involving all of the lungs and pulmonary vessels would predispose to apnea/unstable breathing during sleep. We tested this in a chronically instrumented, unanesthetized dog model during non-rapid eye movement (NREM) sleep. Pulmonary hypertension was created by partial occlusion of the left atrium by means of an implanted balloon catheter in the atrial lumen. Raising mean left atrial pressure by 5.7 +/- 1.1 Torr resulted immediately in tachypneic hyperventilation [breathing frequency increased significantly from 13.8 to 19.9 breaths/min; end-tidal P(CO2) (P(ET(CO2))) fell significantly from 38.5 to 35.9 Torr]. This tachypneic hyperventilation was present during wakefulness, NREM sleep, and rapid eye movement sleep. In NREM sleep, this increase in left atrial pressure increased the gain of the ventilatory response to CO2 below eupnea (1.3 to 2.2 l.min(-1).Torr(-1)) and thereby narrowed the CO2 reserve [P(ET(CO2)) (apneic threshold) - P(ET(CO2)) (eupnea)], despite the decreased plant gain resulting from the hyperventilation. We conclude that acute pulmonary hypertension during sleep results in a narrowed CO2 reserve and thus predisposes toward apnea/unstable breathing and may, therefore, contribute to the breathing instability observed in CHF.     

Regulation of ion transport in eel intestine by the homologous guanylin family of peptides

Since the gene expression of guanylin peptides and their receptors, guanylyl cyclase Cs, is enhanced in the intestine of seawater (SW)-adapted eels compared with fresh water (FW)-adapted fish, the guanylin family may play an important role in SW adaptation in eels. The present study analyzed the effect of three homologous guanylin peptides, guanylin, uroguanylin and renoguanylin, on ion movement through the eel intestine, and examined the target of guanylin action using Ussing chambers. The middle and posterior parts of the intestine, where water and ion absorption occurs actively in SW eels, exhibited serosa-negative transepithelial potential, while the anterior intestine was serosa-positive. Mucosal application of each guanylin in the middle or posterior intestine reduced the short-circuit current (Isc) dose dependently and reversed it at high doses, and reduced electric tissue resistance. The effects were greater in the middle intestine than in the posterior intestine. All three guanylins showed similar potency in the middle segment, but guanylin was more potent in the posterior segment. 8-bromo cGMP mimicked the effect of guanylins. The intestinal response to guanylin was smaller in FW eels. The mucosal presence of NPPB utilized as a CFTR blocker, but not of other inhibitors of the channels/transporters localized on the luminal surface in SW fish intestine, inhibited the guanylin-induced decrease in Isc. In eels, therefore, the guanylin family may be involved in osmoregulation by the intestine by binding to the receptors and activating CFTR-like channels on the mucosal side through cGMP production, perhaps resulting in Cl(-) and HCO3(-) secretion into the lumen.     

Importance of ventilation in modulating interaction between sympathetic drive and cardiovascular variability

Chemoreflex stimulation elicits both hyperventilation and sympathetic activation, each of which may have different influences on oscillatory characteristics of cardiovascular variability. We examined the influence of hyperventilation on the interactions between changes in R-R interval (RR) and muscle sympathetic nerve activity (MSNA) and changes in neurocirculatory variability, in 14 healthy subjects. We performed spectral analysis of RR and MSNA variability during each of the following interventions: 1) controlled breathing, 2) maximal end-expiratory apnea, 3) isocapnic voluntary hyperventilation, and 4) hypercapnia-induced hyperventilation. MSNA increased from 100% during controlled breathing to 170 +/- 25% during apnea (P = 0.02). RR was unchanged, but normalized low-frequency (LF) variability of both RR and MSNA increased markedly (P < 0.001). During isocapnic hyperventilation, minute ventilation increased to 20.2 +/- 1.4 l/min (P < 0.0001). During hypercapnic hyperventilation, minute ventilation also increased (to 19.7 +/- 1.7 l/min) as did end-tidal CO(2) (both P < 0.0001). MSNA remained unchanged during isocapnic hyperventilation (104 +/- 7%) but increased to 241 +/- 49% during hypercapnic hyperventilation (P < 0.01). RR decreased during both isocapnic and hypercapnic hyperventilation (P < 0.05). However, normalized LF variability of RR and of MSNA decreased (P < 0.05) during both isocapnic and hypercapnic hyperventilation, despite the tachycardia and heightened sympathetic nerve traffic. In conclusion, marked respiratory oscillations in autonomic drive induced by hyperventilation may induce dissociation between RR, MSNA, and neurocirculatory variability, perhaps by suppressing central genesis and/or inhibiting transmission of LF cardiovascular rhythms.     

Partitioning of nasal and pulmonary resistance changes during noninvasive plethysmography in mice

Double-chamber plethysmography is a well established noninvasive method of assessing airflow obstruction in small lab animals. It allows measurement of the specific airway resistance (sRaw), which unlike enhanced pause (Penh), is a meaningful airway mechanics parameter. Since sRaw is measured in spontaneously breathing mice, a limitation of the method is the inability to exclude nasal resistance changes. We recently showed that mice are not truly obligate nasal breathers and that after nasal occlusion, nasally breathing mice can transition to an oral mode of breathing. We now show that it is experimentally possible to algebraically separate the average nasal and pulmonary (including laryngeal) components of total airway resistance change by a series of measurements made across groups of mice breathing nasally or orally, assuming that oral resistance remains constant. Using this approach, we show that nasal resistance change comprises one-half or more of the total resistance change during methacholine challenge. Inhibition of mucin secretion from airway goblet cells attenuates pulmonary but not nasal airway hyperresponsiveness (AHR), and nasal AHR in a murine model of rhinitis may be related to edema.