The impact of midcervical contusion injury on diaphragm muscle function

Santiago Alvarez-Argote, Heather M. Gransee, Juan C. Mora, Jessica M. Stowe, Amy J. Jorgenson, Gary C Sieck, Carlos Bernardo Mantilla

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Midcervical contusion injuries disrupt descending ipsilateral excitatory bulbospinal projections to phrenic motoneurons, compromising ventilation. We hypothesized that a unilateral contusion injury at C3 versus C5 would differentially impact phrenic activity reflecting more prominent disruption of ipsilateral descending excitatory drive to more caudal segments of the phrenic motor pool with more cranial injuries. Phrenic motoneuron counts and evidence of diaphragm muscle denervation at individual neuromuscular junctions (NMJ) were evaluated at 14 days post-injury after unilateral contusion injury (100 kDynes). Whole body plethysmography and chronic diaphragm EMG were measured before the injury and at 3, 7, and 14 days post-injury. Contusion injuries at either level resulted in a similarly sized cavity. C3 contusion resulted in loss of 39 ± 13% of ipsilateral phrenic motoneurons compared with 13 ± 21% after C5 contusion (p = 0.003). Cervical contusion injuries resulted in diaphragm muscle denervation (C3 contusion: 17 ± 4%; C5 contusion: 7 ± 4%; p = 0.047). The pattern of denervation revealed segmental innervation of the diaphragm muscle, with greater denervation ventrally after C3 contusion and dorsally after C5 contusion. Overall, diaphragm root mean square electromyography activity did not change ipsilaterally after C3 or C5 contusion, but increased contralaterally (∼11%) after C3 contusion only on the first day post-injury (p = 0.026). Similarly, there were no significant changes in breathing parameters during eupnea or exposure to hypoxia (10% O2) - hypercapnia (5% CO2) at any time post-injury. Unilateral midcervical contusions minimally impair ventilatory behaviors despite phrenic motoneuron loss and diaphragm muscle denervation.

Original languageEnglish (US)
Pages (from-to)500-509
Number of pages10
JournalJournal of Neurotrauma
Volume33
Issue number5
DOIs
StatePublished - Mar 1 2016

Fingerprint

Contusions
Diaphragm
Muscles
Wounds and Injuries
Muscle Denervation
Motor Neurons
Denervation
Whole Body Plethysmography
Hypercapnia
Neuromuscular Junction
Electromyography
Ventilation
Respiration

Keywords

  • level of injury
  • neuromuscular junction
  • phrenic motoneuron
  • spinal cord injury
  • ventilation

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Alvarez-Argote, S., Gransee, H. M., Mora, J. C., Stowe, J. M., Jorgenson, A. J., Sieck, G. C., & Mantilla, C. B. (2016). The impact of midcervical contusion injury on diaphragm muscle function. Journal of Neurotrauma, 33(5), 500-509. https://doi.org/10.1089/neu.2015.4054

The impact of midcervical contusion injury on diaphragm muscle function. / Alvarez-Argote, Santiago; Gransee, Heather M.; Mora, Juan C.; Stowe, Jessica M.; Jorgenson, Amy J.; Sieck, Gary C; Mantilla, Carlos Bernardo.

In: Journal of Neurotrauma, Vol. 33, No. 5, 01.03.2016, p. 500-509.

Research output: Contribution to journalArticle

Alvarez-Argote, S, Gransee, HM, Mora, JC, Stowe, JM, Jorgenson, AJ, Sieck, GC & Mantilla, CB 2016, 'The impact of midcervical contusion injury on diaphragm muscle function', Journal of Neurotrauma, vol. 33, no. 5, pp. 500-509. https://doi.org/10.1089/neu.2015.4054
Alvarez-Argote S, Gransee HM, Mora JC, Stowe JM, Jorgenson AJ, Sieck GC et al. The impact of midcervical contusion injury on diaphragm muscle function. Journal of Neurotrauma. 2016 Mar 1;33(5):500-509. https://doi.org/10.1089/neu.2015.4054
Alvarez-Argote, Santiago ; Gransee, Heather M. ; Mora, Juan C. ; Stowe, Jessica M. ; Jorgenson, Amy J. ; Sieck, Gary C ; Mantilla, Carlos Bernardo. / The impact of midcervical contusion injury on diaphragm muscle function. In: Journal of Neurotrauma. 2016 ; Vol. 33, No. 5. pp. 500-509.
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abstract = "Midcervical contusion injuries disrupt descending ipsilateral excitatory bulbospinal projections to phrenic motoneurons, compromising ventilation. We hypothesized that a unilateral contusion injury at C3 versus C5 would differentially impact phrenic activity reflecting more prominent disruption of ipsilateral descending excitatory drive to more caudal segments of the phrenic motor pool with more cranial injuries. Phrenic motoneuron counts and evidence of diaphragm muscle denervation at individual neuromuscular junctions (NMJ) were evaluated at 14 days post-injury after unilateral contusion injury (100 kDynes). Whole body plethysmography and chronic diaphragm EMG were measured before the injury and at 3, 7, and 14 days post-injury. Contusion injuries at either level resulted in a similarly sized cavity. C3 contusion resulted in loss of 39 ± 13{\%} of ipsilateral phrenic motoneurons compared with 13 ± 21{\%} after C5 contusion (p = 0.003). Cervical contusion injuries resulted in diaphragm muscle denervation (C3 contusion: 17 ± 4{\%}; C5 contusion: 7 ± 4{\%}; p = 0.047). The pattern of denervation revealed segmental innervation of the diaphragm muscle, with greater denervation ventrally after C3 contusion and dorsally after C5 contusion. Overall, diaphragm root mean square electromyography activity did not change ipsilaterally after C3 or C5 contusion, but increased contralaterally (∼11{\%}) after C3 contusion only on the first day post-injury (p = 0.026). Similarly, there were no significant changes in breathing parameters during eupnea or exposure to hypoxia (10{\%} O2) - hypercapnia (5{\%} CO2) at any time post-injury. Unilateral midcervical contusions minimally impair ventilatory behaviors despite phrenic motoneuron loss and diaphragm muscle denervation.",
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