Advancing respiratory-cardiovascular physiology with the working heart-brainstem preparation over 25 years

Twenty‐five years ago, a new physiological preparation called the working heart–brainstem preparation (WHBP) was introduced with the claim it would provide a new platform allowing studies not possible before in cardiovascular, neuroendocrine, autonomic and respiratory research. Herein, we review some of the progress made with the WHBP, some advantages and disadvantages along with potential future applications, and provide photographs and technical drawings of all the customised equipment used for the preparation. Using mice or rats, the WHBP is an in situ experimental model that is perfused via an extracorporeal circuit benefitting from unprecedented surgical access, mechanical stability of the brain for whole cell recording and an uncompromised use of pharmacological agents akin to in vitro approaches. The preparation has revealed novel mechanistic insights into, for example, the generation of distinct respiratory rhythms, the neurogenesis of sympathetic activity, coupling between respiration and the heart and circulation, hypothalamic and spinal control mechanisms, and peripheral and central chemoreceptor mechanisms. Insights have been gleaned into diseases such as hypertension, heart failure and sleep apnoea. Findings from the in situ preparation have been ratified in conscious in vivo animals and when tested have translated to humans. We conclude by discussing potential future applications of the WHBP including two‐photon imaging of peripheral and central nervous systems and adoption of pharmacogenetic tools that will improve our understanding of physiological mechanisms and reveal novel mechanisms that may guide new treatment strategies for cardiorespiratory diseases.

Mylohyoid discharge of the in situ rat: a probe of pontile respiratory activities in eupnea and gasping

Our purpose was to characterize respiratory-modulated activity of the mylohyoid nerve. Since its motoneurons are in the trigeminal motor nucleus, mylohyoid discharge could serve as a probe of the role of pontile mechanisms in the generation of respiratory rhythms. Studies were performed in the decerebrate, perfused in situ preparation of the rat. Phrenic discharge was recorded as the index of the respiratory rhythm. In eupnea, the mylohyoid nerve discharged primarily during neural expiration, in the period between phrenic bursts. This expiratory discharge increased greatly in hypoxia and fell in hypercapnia. The hypoxia-induced increase in mylohyoid discharge was due, at least in part, to a direct influence of hypoxia on the brain stem. In ischemia, phrenic discharge increased, and then declined to apnea, which was succeeded by gasping. The mylohyoid nerve discharged tonically during the apneic period, but still declined during each of the phrenic bursts of gasping. This maintenance of a respiratory-modulation of the mylohyoid discharge in gasping supports the concept that a release of medullary mechanisms, rather than a ubiquitous suppression of pontile influences, underlies the neurogenesis of gasping. Results also provide additional support for our conclusion that activity of any single cranial nerve does not provide an accurate index of the type of respiratory rhythm, be it eupnea or gasping.

Multiple pontomedullary mechanisms of respiratory rhythmogenesis

Mammalian central pattern generators producing rhythmic movements exhibit robust but flexible behavior. However, brainstem network architectures that enable these features are not well understood. Using precise sequential transections through the pons to medulla, it was observed that there was compartmentalization of distinct rhythmogenic mechanisms in the ponto-medullary respiratory network, which has rostro-caudal organization. The eupneic 3-phase respiratory pattern was transformed to a 2-phase and then to a 1-phase pattern as the network was physically reduced. The pons, the retrotrapezoid nucleus and glycine mediated inhibition are all essential for expression of the 3-phase rhythm. The 2-phase rhythm depends on inhibitory interactions (reciprocal) between Bötzinger and pre-Bötzinger complexes, whereas the 1-phase-pattern is generated within the pre-Bötzinger complex and is reliant on the persistent sodium current. In conditions of forced expiration, the RTN region was found to be essential for the expression of abdominal late expiratory activity. However, it is unknown whether the RTN generates or simply relays this activity. Entrained with the central respiratory network is the sympathetic nervous system, which exhibits patterns of discharge coupled with the respiratory cycle (in terms of both gain and phase of coupling) and dysfunctions in this coupling appear to underpin pathological conditions. In conclusion, the respiratory network has rhythmogenic capabilities at multiple levels of network organization, allowing expression of motor patterns specific for various physiological and pathophysiological respiratory behaviors.

Location and properties of respiratory neurones with putative intrinsic bursting properties in the rat in situ

Using the in situ arterially perfused preparations of both neonatal and juvenile rats, we provide the first description of the location, morphology and transmitter content of a population of respiratory neurones that retains a bursting behaviour after ionotropic receptor blockade. All burster neurones exhibited an inspiratory discharge during eupnoeic respiration. These neurones were predominantly glutamatergic, and were located within a region of the ventral respiratory column that encompasses the pre-Bötzinger complex and the more caudally located ventral respiratory group. Bursting behaviour was both voltage and persistent sodium current dependent and could be stimulated by sodium cyanide to activate this persistent sodium current. The population of burster neurones may overlap with that previously described in the neonatal slice in vitro. Based upon the present and previous findings, we hypothesize that this burster discharge may be released when the brain is subject to severe hypoxia or ischaemia, and that this burster discharge could underlie gasping.

Genesis of gasping is independent of levels of serotonin in the Pet-1 knockout mouse

Eupnea is normal breathing. If eupnea fails, as in severe hypoxia or ischemia, gasping is recruited. Gasping can serve as a powerful mechanism for autoresuscitation. A failure of autoresuscitation has been proposed as a basis of the sudden infant death syndrome. In an in vitro preparation, endogenous serotonin is reported to be essential for expression of gasping. Using an in situ preparation of the Pet-1 knockout mouse, we evaluated such a critical role for serotonin. In this mouse, the number of serotonergic neurons is reduced by 85-90% compared with animals without this homozygous genetic defect. Despite this reduction in the number of serotonergic neurons, phrenic discharge in eupnea and gasping of Pet-1 knockout mice was not different from that of wild-type mice. Indeed, gasping continued unabated, even after administration of methysergide, a blocker of many types of receptors for serotonin, to Pet-1 knockout mice. We conclude that serotonin is not critical for expression of gasping. The proposal for such a critical role, on the basis of observations in the in vitro slice preparation, may reflect the minimal functional neuronal tissue and neurotransmitters in this preparation, such that the role of any remaining neurotransmitters is magnified. Also, rhythmic activity of the in vitro slice preparation has been characterized as eupnea or gasping solely on the basis of activity of the hypoglossal nerve or massed neuronal activities of the ventrolateral medulla. The accuracy of this method of classification has not been established.

Maintenance of gasping and restoration of eupnea after hypoxia is impaired following blockers of alpha1-adrenergic receptors and serotonin 5-HT2 receptors

In severe hypoxia or ischemia, normal eupneic breathing fails and is replaced by gasping. Gasping serves as part of a process of autoresuscitation by which eupnea is reestablished. Medullary neurons, having a burster, pacemaker discharge, underlie gasping. Conductance through persistent sodium channels is essential for the burster discharge. This conductance is modulated by norepinephrine, acting on alpha 1-adrenergic receptors, and serotonin, acting on 5-HT2 receptors. We hypothesized that blockers of 5-HT2 receptors and alpha 1-adrenergic receptors would alter autoresuscitation. The in situ perfused preparation of the juvenile rat was used. Integrated phrenic discharge was switched from an incrementing pattern, akin to eupnea, to the decrementing pattern comparable to gasping in hypoxic hypercapnia. With a restoration of hyperoxic normocapnia, rhythmic, incrementing phrenic discharge returned within 10 s in most preparations. Following addition of blockers of alpha 1-adrenergic receptors (WB-4101, 0.0625-0.500 microM) and/or blockers of 5-HT2 (ketanserin, 1.25-10 microM) or multiple 5-HT receptors (methysergide, 3.0-10 microM) to the perfusate, incrementing phrenic discharge continued. Fictive gasping was still induced, although it ceased after significantly fewer decrementing bursts than in preparations than received no blockers. Moreover, the time for recovery of rhythmic activity was significantly prolonged. This prolongation was in excess of 100 s in all preparations that received both WB-4101 (above 0.125 microM) and methysergide (above 2.5 microM). We conclude that activation of adrenergic and 5-HT2 receptors is important to sustain gasping and to restore rhythmic respiratory activity after hypoxia-induced depression.

Eupnea of in situ rats persists following blockers of in vitro pacemaker burster activities

Two groups of intrinsically bursting neurons, linked to respiration, have been identified using in vitro medullary slice preparations. One group is dependent upon a calcium-activated nonspecific cationic current that is blocked by flufanemic acid. This group is hypothesized as essential for eupnea, but not gasping. The second group is dependent upon conductance through persistent sodium channels that is blocked by riluzole. This group is proposed to underlie both eupnea and gasping. In the decerebrate in situ preparation of the juvenile rat, flufanemic acid caused an increase in frequency and a decrease in peak level of the phrenic and vagus nerve activities in both eupnea and gasping. Similar changes in eupnea followed the simultaneous blockades by flufanemic acid and riluzole. However, gasping was eliminated. These results do not support the hypothesis that conductances through either persistent sodium channels or calcium-activated nonspecific cationic channels are essential for the neurogenesis of eupnea. However, gasping does depend upon a conductance through persistent sodium channels.

Persistence of eupnea and gasping following blockade of both serotonin type 1 and 2 receptors in the in situ juvenile rat preparation

In severe hypoxia or ischemia, normal eupneic breathing is replaced by gasping, which can serve as a powerful mechanism for "autoresuscitation." We have proposed that gasping is generated by medullary neurons having intrinsic pacemaker bursting properties dependent on a persistent sodium current. A number of neuromodulators, including serotonin, influence persistent sodium currents. Thus we hypothesized that endogenous serotonin is essential for gasping to be generated. To assess such a critical role for serotonin, a preparation of the perfused, juvenile in situ rat was used. Activities of the phrenic, hypoglossal, and vagal nerves were recorded. We added blockers of type 1 and/or type 2 classes of serotonergic receptors to the perfusate delivered to the preparation. Eupnea continued following additions of any of the blockers. Changes were limited to an increase in the frequency of phrenic bursts and a decline in peak heights of all neural activities. In ischemia, gasping was induced following any of the blockers. Few statistically significant changes in parameters of gasping were found. We thus did not find a differential suppression of gasping, compared with eupnea, following blockers of serotonin receptors. Such a differential suppression had been proposed based on findings using an in vitro preparation. We hypothesize that multiple neurotransmitters/neuromodulators influence medullary mechanisms underlying the neurogenesis of gasping. In greatly reduced in vitro preparations, the importance of any individual neuromodulator, such as serotonin, may be exaggerated compared with its role in more intact preparations.

High-frequency oscillations in phrenic activity during pontile and medullary respiratory rhythms in rats

High-frequency oscillations may be signatures of the basic mechanisms underlying the neurogenesis of various patterns of automatic ventilatory activity. These high-frequency oscillations in phrenic activity differ greatly in eupnoea and gasping, implying different mechanisms of neurogenesis. In a decerebrate, in situ preparation of the rat, the peak frequency of high-frequency oscillations fell in apneusis following removal of the rostral pons. Following removal of all pons, phrenic discharge had a mixed pattern of gasps and multiple bursts; some of the latter were incrementing, as in eupnoea. Regardless of pattern, peak frequencies were significantly below those which were found during eupnoea, apneusis or gasping of the decerebrate preparation. Results do not support the concept that 'non-gasping' rhythmic patterns that can be recorded following a removal of pons are generated by the same mechanisms as those generating eupnoea. Indeed, both pons and medulla appear essential for all aspects of eupnoea to be expressed.

Changes in respiratory-modulated neural activities, consistent with obstructive and central apnea, during fictive seizures in an in situ anaesthetized rat preparation

Sudden unexplained death in epilepsy (SUDEP) has been proposed to result from seizure-induced changes in respiratory and cardiac function. Our purpose was to characterize changes in respiration during seizures. We used a preparation of the anaesthetized, perfused in situ rat. This preparation has the advantage over in vivo preparations in that delivery of oxygen to the brain does not depend upon the lungs or cardiovascular system. Electroencephalographic activity was recorded as were activities of the hypoglossal, vagus and phrenic nerves. The hypoglossal and vagus nerves innervate muscles of the upper airway and larynx while the phrenic nerve innervates the diaphragm. Fictive seizures were elicited by injections of penicillin into the parietal cortex or the carotid artery. Following elicitation of the fictive seizures, activities of the hypoglossal and vagal nerves declined greatly while phrenic activity was little altered. Such a differential depression of activities of nerves to the upper airway and larynx, compared to that to the diaphragm, would predispose to obstructive apnea in intact preparations. With more time, activity of the phrenic nerve also declined or ceased. These changes characterize central apnea. The major conclusion is that seizures may result in recurrent periods of obstructive and central apnea. Thus, seizures can adversely alter respiratory function in a profound manner.

Maintenance of eupnea of in situ and in vivo rats following riluzole: a blocker of persistent sodium channels

We have proposed a "switching" concept for the neurogenesis of breathing in which rhythm generation by a pontomedullary neuronal circuit for eupnea may be switched to a medullary pacemaker system for gasping. This switch involves activation of conductances through persistent sodium channels. Based upon this proposal, eupnea should continue following a blockade of persistent sodium channels. In situ preparations of the decerebrate, juvenile rat were studied in normocapnia, hypocapnia and hypercapnia. Regardless of the level of CO(2) drive, riluzole (1-10 microM), a blocker of persistent sodium channels, caused increases in the frequency and reductions in peak integrated phrenic height. Even 20 microM of riluzole, a concentration four-fold higher than that which eliminates gasping, did not cause a cessation of phrenic discharge. In conscious, rats breathing continued unabated following intravenous administrations of 3-9 mgkg(-1) of riluzole. These administrations did cause sedation. We conclude that conductance through persistent sodium channels plays little role in the neurogenesis of eupnea.

Gap junction blockade does not alter eupnea or gasping in the juvenile rat

The role of gap junctions in the brainstem respiratory control system is ambiguous. In the present study, we used juvenile rats to determine whether blocking gap junctions altered eupnea or gasping in the in situ, arterially perfused rat preparation. Blockade of gap junctions with 100 microM carbenoxolone or 300 microM octanol did not produce any consistent changes in the timing or amplitude of integrated phrenic discharge or in the peak frequency in the power spectrum of phrenic nerve discharge during eupnea or ischemic gasping beyond those changes seen in time-control animals. These findings do not rule out a role for gap junctions in the expression of eupnea or gasping, but they do demonstrate that these intermembrane channels are not obligatory for either rhythm to occur.

Respiratory rhythm generation during gasping depends on persistent sodium current

In severe hypoxia, homeostatic mechanisms maintain function of the brainstem respiratory network. We hypothesized that hypoxia involves a transition from neuronal mechanisms of normal breathing (eupnea) to a rudimentary pattern of inspiratory movements (gasping). We provide evidence for hypoxia-driven transformation within the central respiratory oscillator, in which gasping relies on persistent sodium current, whereas eupnea does not depend on this cellular mechanism.

Long-term intracellular recordings of respiratory neuronal activities in situ during eupnea, gasping and blockade of synaptic transmission

For a definitive evaluation of the hypothesis that different neurophysiological mechanisms underlie the neurogenesis of eupnea and gasping, long-term continuous intracellular recordings of respiratory neuronal activities during both respiratory patterns are required. Such recordings in vivo are technically difficult, especially in small mammals, due to mechanical instability of the brainstem and cardiovascular depression that accompany hypoxia-induced gasping. Respiratory-related rhythmic activities of in vitro preparations are confounded by the lack of a clear correspondence with both eupnea and gasping. Here, we describe new methodologies and report on whole cell patch clamp recordings from the ventrolateral medulla and the hypoglossal motor nucleus in situ during multiple bouts of hypoxia-induced gasping. The longevity of recordings (range 20--35 min) also allowed subsequent analysis of neuronal behaviour after blockade of inhibitory and excitatory synaptic activities. We conclude that whole cell patch clamp recordings in the in situ preparation will allow an analysis of both synaptic and ionic conductances of respiratory neurons during defined eupnea and gasping, providing an additional approach to in vitro preparations.

Maintenance of eupnea and gasping following alterations in potassium ion concentration of perfusates of in situ rat preparation

Levels of extracellular potassium ion, above those in vivo, are required for the generation of rhythmic activities of in vitro preparations. Our purpose was to define whether hyperkalemia in the perfusate of an in situ preparation was likewise necessary for the expression of eupnea and gasping. Studies were performed using the in situ preparation of the juvenile rat, in which activity of the phrenic nerve was recorded as an index of the respiratory rhythm. Eupnea and gasping were impervious to modifications of potassium ion of the perfusate. Eupnea was maintained uninterrupted for more than 60 min whether the total concentration of potassium was hypokalemic (2.75 mM), normokalemic (4.0 mM), or hyperkalemic (6.25 and 7.75 mM). Gasping, with identical characteristics, was elicited at any concentration of potassium ion. We conclude that both eupnea and gasping are unaffected by modest changes in the concentration of potassium ion in the perfusate with which the in situ rat preparation is maintained. These results add further support to the conclusion that the in situ preparation represents a model that accurately reproduces mechanisms of rhythm generation of both eupnea and gasping in vivo.

Phasic pulmonary stretch receptor feedback modulates both eupnea and gasping in an in situ rat preparation

The perfused in situ juvenile rat preparation produces patterns of phrenic discharge comparable to eupnea and gasping in vivo. These ventilatory patterns differ in multiple aspects, including most prominently the rate of rise of inspiratory activity. Although we have recently demonstrated that both eupnea and gasping are similarly modulated by a Hering-Breuer expiratory-promoting reflex to tonic pulmonary stretch, it has generally been assumed that gasping was unresponsive to afferent stimuli from pulmonary stretch receptors. In the present study, we recorded eupneic and gasplike efferent activity of the phrenic nerve in the in situ juvenile rat perfused brain stem preparation, with and without phrenic-triggered phasic pulmonary inflation. We tested the hypothesis that phasic pulmonary inflation produces reflex responses in situ akin to those in vivo and that both eupnea and gasping are similarly modulated by phasic pulmonary stretch. In eupnea, we found that phasic pulmonary inflation decreases inspiratory burst duration and the period of expiration, thus increasing burst frequency of the phrenic neurogram. Phasic pulmonary inflation also decreases the duration of expiration and increases the burst frequency during gasping. Bilateral vagotomy eliminated these changes. We conclude that the neural substrate mediating the Hering-Breuer reflex is retained in the in situ preparation and that the brain stem circuitry generating the respiratory patterns respond to phasic activation of pulmonary stretch receptors in both eupnea and gasping. These findings support the homology of eupneic phrenic discharge patterns in the reduced in situ preparation and eupnea in vivo and disprove the common supposition that gasping is insensitive to vagal afferent feedback from pulmonary stretch receptor mechanisms.

Modeling the ponto-medullary respiratory network

The generation and shaping of the respiratory motor pattern are performed in the lower brainstem and involve neuronal interactions within the medulla and between the medulla and pons. A computational model of the ponto-medullary respiratory network has been developed by incorporating existing experimental data on the medullary neural circuits and possible interactions between the medulla and pons. The model reproduces a number of experimental findings concerning alterations of the respiratory pattern following various perturbations/stimulations applied to the pons and pulmonary afferents. The results of modeling support the concept that eupneic respiratory rhythm generation requires contribution of the pons whereas a gasping-like rhythm (and the rhythm observed in vitro) may be generated within the medulla and involve pacemaker-driven mechanisms localized within the medullary pre-Botzinger Complex. The model and experimental data described support the concept that during eupnea the respiration-related pontine structures control the medullary network mechanisms for respiratory phase transitions, suppress the intrinsic pacemaker-driven oscillations in the pre-BotC and provide inspiration-inhibitory and expiration-facilitatory reflexes which are independent of the pulmonary Hering-Breuer reflex but operate through the same medullary phase switching circuits.

Role of pontile mechanisms in the neurogenesis of eupnea

We have proposed a "switching concept" for the neurogenesis of ventilatory activity. Eupnea reflects the output of a pontomedullary neuronal circuit, whereas gasping is generated by medullary pacemaker mechanisms. Pontile mechanisms, then, are hypothesized to play a fundamental role in the neurogenesis of eupnea. If pontile mechanisms do play such a critical role, several criteria must be fulfilled. First, perturbations of pontile regions must alter eupnea under all experimental conditions. Second, neuronal activities that are consistent with generating the eupneic rhythm must be recorded in pons. Finally, medullary mechanisms alone cannot fully explain the neurogenesis of eupnea. Evidence from previous studies that support the validity of these criteria is presented herein. We conclude that pontile mechanisms play a critical role in the neurogenesis of eupnea.

Uncoupling of rhythmic hypoglossal from phrenic activity in the rat

During eupnoea, rhythmic motor activities of the hypoglossal, vagal and phrenic nerves are linked temporally. The inspiratory discharges of the hypoglossal and vagus motor neurones commence before the onset of the phrenic burst. The vagus nerve also discharges in expiration. Upon exposure to hypocapnia or hypothermia, the hypoglossal discharge became uncoupled from that of the phrenic nerve. This uncoupling was evidenced by variable times of onset of hypoglossal discharge before or after the onset of phrenic discharge, extra bursts of hypoglossal activity in neural expiration, or complete absence of any hypoglossal discharge during a respiratory cycle. No such changes were found for vagal discharge, which remained linked to the phrenic bursts. Intracellular recordings in the hypoglossal nucleus revealed that all changes in hypoglossal discharge were due to neuronal depolarization. These results add support to the conclusion that the brainstem control of respiratory-modulated hypoglossal activity differs from control of phrenic and vagal activity. These findings have implications for any studies in which activity of the hypoglossal nerve is used as the sole index of neural inspiration. Indeed, our results establish that hypoglossal discharge alone is an equivocal index of the pattern of overall ventilatory activity and that this is accentuated by hypercapnia and hypothermia.

High-frequency oscillations of phrenic activity in eupnea and gasping of in situ rat: influence of temperature

We hypothesized that the in situ perfused preparation of the juvenile rat exhibits patterns of ventilatory activity comparable to eupnea and gasping in vivo. To evaluate this hypothesis, we examined high-frequency oscillations of activity of the phrenic nerve at 27-34 degrees C. The peak frequency of these high-frequency oscillations was defined from power spectral analysis. In situ, recordings were obtained in hyperoxic normocapnia, during ventilatory cycles in which the peak of integrated phrenic activity was achieved late in the burst, as in eupnea in vivo. Recordings were also obtained in hypoxic hypercapnia, when the peak of integrated phrenic activity occurred in the first half of the burst, as in gasping in vivo. In situ, peak frequencies in the power spectra were significantly higher in gasping than during eupnea. Frequencies during eupnea and gasping were progressively elevated as the temperature of the in situ preparation was increased. The shift in peak frequencies between eupnea and gasping and the temperature sensitivity of frequencies in situ were the same as in vivo. Results provide additional support for the conclusion that the in situ preparation demonstrates distinctly different patterns of automatic ventilatory activity, comparable to eupnea and gasping in vivo.

Endogenous rhythm generation in the pre-Bötzinger complex and ionic currents: modelling and in vitro studies

The pre-Bötzinger complex is a small region in the mammalian brainstem involved in generation of the respiratory rhythm. As shown in vitro, this region, under certain conditions, can generate endogenous rhythmic bursting activity. Our investigation focused on the conditions that may induce this bursting behaviour. A computational model of a population of pacemaker neurons in the pre-Bötzinger complex was developed and analysed. Each neuron was modelled in the Hodgkin-Huxley style and included persistent sodium and delayed-rectifier potassium currents. We found that the firing behaviour of the model strongly depended on the expression of these currents. Specifically, bursting in the model could be induced by a suppression of delayed-rectifier potassium current (either directly or via an increase in extracellular potassium concentration, [K+]o) or by an augmentation of persistent sodium current. To test our modelling predictions, we recorded endogenous population activity of the pre-Bötzinger complex and activity of the hypoglossal (XII) nerve from in vitro transverse brainstem slices (700 micro m) of neonatal rats (P0-P4). Rhythmic activity was absent at 3 mm[K+]o but could be triggered by either the elevation of [K+]o to 5-7 mm or application of potassium current blockers (4-AP, 50-200 micro m, or TEA, 2 or 4 mm), or by blocking aerobic metabolism with NaCN (2 mm). This rhythmic activity could be abolished by the persistent sodium current blocker riluzole (25 or 50 micro m). These findings are discussed in the context of the role of endogenous bursting activity in the respiratory rhythm generation in vivo vs. in vitro and during normal breathing in vivo vs. gasping.

Characterization of hypoxia-induced ventilatory depression in newborn piglets

We evaluated the hypothesis that a 'central oxygen detector' in the brainstem is necessary for depressions of ventilatory activity to be manifested in the newborn. Decerebrate piglets, ventilated with 100 % O(2), were studied following neuromuscular blockade. The vagi and carotid sinus nerves were sectioned bilaterally in order to remove the influence of the peripheral chemoreceptors. Activity of the phrenic nerve was recorded as the index of the central respiratory rhythm. This activity declined and, in some preparations, ceased upon ventilation with air or a hypoxic gas, at either normocapnia or hypercapnia. The degree of depression in hypercapnic hypoxia was greatest in the youngest piglets. Following a medial section of the brainstem, extending to the caudal pons, the depression was reduced. In some preparations, a similar reduction followed the placement of radiofrequency lesions in the caudal ventromedial pons. We conclude that a region of the caudal mesencephalon or pons is necessary for the manifestation of depressions of ventilatory activity in the newborn pig.

Respiratory-modulated neuronal activities of the rostral medulla which may generate gasping

Different neurophysiological mechanisms have been proposed to generate eupnea and gasping. Gasping is generated by neuronal mechanisms intrinsic to the medulla whereas a ponto-medullary neuronal circuit has been hypothesized to generate eupnea. Hence, neurons in the rostral medullary region which are critical for the neurogenesis of gasping are hypothesized to discharge differently in eupnea and gasping. In a perfused in situ preparation of the juvenile rat, these rostral medullary neuronal activities had inspiratory, expiratory and phase-spanning patterns in eupnea. In gasping, most expiratory and phase-spanning activities ceased, whereas many inspiratory neuronal activities changed to a decrementing pattern as that of the phrenic nerve. A limited proportion of neuronal activities acquired a 'pre-inspiratory' discharge in gasping. These neuronal activities, which were inspiratory or phase-spanning in eupnea, commenced discharge in neural expiration. This discharge peaked at the onset of the gasp and then decremented during neural inspiration. We hypothesize that these 'pre-inspiratory' neuronal activities generate the gasp by intrinsic pacemaker mechanisms.

Gasping is elicited by briefer hypoxia or ischemia following blockade of glycinergic transmission

The 'switching model' for generation of respiratory rhythms holds that gasping represents the release of a rostral medullary pacemaker mechanism from the pontomedullary neuronal circuit that generates eupnea. In a perfused preparation of the decerebrate juvenile rat, exposure to ischemia or hypoxic-hypercapnia caused an alteration in integrated phrenic activity from the incrementing pattern of eupnea to the decrementing pattern of gasping. The time required to elicit gasping was not altered by multiple exposures to ischemia or hypoxic-hypercapnia. Furthermore, this time to gasping was not altered following addition to the perfusate of increasing concentrations of bicuculline or picrotoxin; both block GABA(A) receptors. Addition to the perfusate of strychnine, a glycine antagonist, significantly shortened the duration of ischemia or hypoxic-hypercapnia required to elicit gasping. These results support the concept that a loss of inhibitory glycinergic transmission is a critical factor in release of pacemaker mechanisms for gasping from the pontomedullary neuronal circuit for eupnea.

Neurogenesis of gasping does not require inhibitory transmission using GABA(A) or glycine receptors

We evaluated the hypothesis that the neurogenesis of gasping is not dependent upon inhibitory synaptic transmission involving GABA(A) or glycine receptors. Activity of the phrenic nerve was recorded in a perfused juvenile rat preparation. The pattern of phrenic activity was altered from eupnea to gasping in severe hypoxia or ischaemia. To block GABA(A) receptors, bicuculline or picrotoxin was administered. Strychnine was used to block transmission by glycine. Following administrations of bicuculline, picrotoxin or strychnine, the eupneic rhythm was greatly distorted whereas the decrementing pattern of the gasp was maintained. At high concentrations of these antagonists, the frequency of gasps was increased and the peak height of gasps fell. We conclude that the neurogenesis of gasping is not dependent upon fast, chloride-mediated inhibitory synaptic transmission.

Characterizations of eupnea, apneusis and gasping in a perfused rat preparation

In vivo mammalian preparations can exhibit eupnea, apneusis and gasping. In vitro mammalian preparations exhibit only a single invariant pattern, which appears identical to gasping. We characterized the patterns of ventilatory activity of a perfused heart-brainstem preparation of the juvenile rat. In this preparation, phrenic activity has a 'ramp-like' rise similar to eupnea in vivo. Peak phrenic activity declines and ultimately disappears in hypocapnia. In hypercapnia, both frequency and peak of phrenic bursts increase. In hypoxia, such increases are transient. The phrenic burst is terminated by electrical stimulation of the pontile 'pneumotaxic center' and, as in apneusis, is prolonged by lesions in this region. With severe hypoxia or ischemia, the 'ramp-like' phrenic activity is replaced by the 'decrementing' pattern of gasping. Variables of phrenic activity in gasping produced in hypoxia and ischemia are identical. We conclude that the perfused juvenile rat preparation exhibits patterns of eupnea, apneusis and gasping which are similar to in vivo mammalian preparations.

Sensitivities of eupnea and gasping to alterations in temperature of in vivo and perfused rat preparations

Severe hypoxia or ischemia causes an alteration from eupnea to gasping. At body temperatures approximating 37 degrees C in vivo, the frequency of gasping is much less than that of eupnea. However in a perfused juvenile rat preparation, which is maintained at 30-31 degrees C, the frequency of eupnea and gasping is the same. We hypothesized that brainstem mechanisms responsible for the neurogenesis of eupnea and gasping might have different sensitivities to alterations in temperature. In both decerebrate adult rats in vivo and in a perfused juvenile rat preparation, eupnea and gasping had different frequencies at rectal or perfusate temperatures in excess of 34 degrees C, whereas, at lower temperatures, eupnea and gasping had identical frequencies in both preparations. These findings support the conclusion that different brainstem mechanisms underlie the neurogenesis of eupnea and gasping. In addition, these findings have implications for interpretation of results from in vitro mammalian preparations, which are examined at temperatures at which the frequency of eupnea and gasping are indistinguishable.

Transient, reversible apnoea following ablation of the pre-Bötzinger complex in rats

1. In some anaesthetized preparations, eupnoea is eliminated following a blockade or destruction of neurons in a rostral medullary pre-Botzinger complex. 2. Neurons in this region might underlie the neurogenesis of eupnoea, or be the source of an input which is necessary for eupnoea to be expressed. If the latter, any apnoea following ablation of the pre-Botzinger complex might be reversed by an augmentation in 'tonic input.' Contrariwise, this apnoea should be permanent if the neuronal activities of the pre- Botzinger complex are an exclusive generator of the eupnoeic rhythm. 3. Decerebrate, vagotomized, paralysed and ventilated adult rats were studied. Efferent activity of the phrenic nerve was recorded as an index of ventilatory activity. 4. Blockade or destruction of neuronal activities of the pre-Botzinger complex by unilateral and/or bilateral injections of muscimol or kainic acid eliminated eupnoea only transiently. Eupnoea returned following activation of the peripheral chemoreceptors and spontaneously over time. 5. Results do not support the concept that neuronal activities of the pre-Botzinger complex play an exclusive role in the neurogenesis of eupnoea in vivo. Rather, these neuronal activities appear to provide a tonic input to the ponto-medullary circuit which generates eupnoea and/or appear to be one component of this circuit.

Maternal nicotine depresses eupneic ventilation of neonatal rats

Maternal smoking is a risk factor for the sudden infant death syndrome (SIDS). We hypothesized that pre-natal exposure to nicotine would result in abnormalities of ventilatory activity in newborns. Neonatal rats which had been exposed to nicotine had significantly lower minute ventilation breathing air and hypoxic gas mixtures than did control animals. In both groups, anoxia elicited gasping which was equally effective in restoring eupnea. Maternal exposure to nicotine may result in a reduced metabolic rate and/or chronic hypoventilation in the newborn.

Modulation of hypoxic depressions of ventilatory activity in the newborn piglet by mesencephalic mechanisms

In neonates, ventilatory responses to hypoxia are 'biphasic,' with an augmentation followed by a decline. The hypoxia-induced augmentations in ventilation are attenuated and the depressions are accentuated following denervation of the peripheral chemoreceptors. Piglets that were decerebrated at a rostral mesencephalic level exhibited these hypoxia-induced depressions. These depressions were lessened following transection through the caudal mesencephalon. Mesencephalic mechanisms play a fundamental role in the brainstem regulation of ventilatory responses to hypoxia.

Alterations in respiratory neuronal activities in the medullary 'pre-Bötzinger' region in hypocapnia

'Pre-inspiratory' neuronal activities in a rostral ventrolateral medullary 'pre-Bötzinger' complex have been hypothesized to generate eupnea. Respiratory-modulated neuronal activities were recorded in this region in decerebrate, vagotomized, paralyzed, and ventilated cats, having bilateral carotid sinus nerve sections. As end-tidal partial pressures of carbon dioxide were reduced to hypocapnic levels, all neuronal activities which were tonic or expiratory inspiratory ('pre-inspiratory') either ceased or lost respiratory-modulation. Similarly, most expiratory and inspiratory expiratory activities did not maintain a phasic discharge. Half of the inspiratory neuronal activities did continue a phasic discharge, which commenced after phrenic activity or became independent of the phrenic rhythm. Results do not support a fundamental role of the 'pre-Bötzinger' complex in the neurogenesis of eupnea. Some neuronal activities can establish a phasic discharge in hypocapnia which is independent of the central respiratory rhythm. At normocapnia, this independent discharge is superseded and incorporated into the ponto-medullary respiratory neuronal circuit which generates eupnea.

Neurogenesis of patterns of automatic ventilatory activity

Normal respiration, termed eupnea, is characterized by periodic filling and emptying of the lungs. Eupnea can occur 'automatically' without conscious effort. Such automatic ventilation is controlled by the brainstem respiratory centers of pons and medulla. Following removal of the pons, eupnea is replaced by gasping, marked by brief but maximal inspiratory efforts. The mechanisms by which the respiratory rhythms are generated have been examined intensively. Evidence is discussed that ventilatory activity can be generated in multiple regions of pons and medulla. Eupnea and gasping represent fundamentally different ventilatory patterns. Only for gasping has a critical region for neurogenesis been identified, in the rostral medulla. Gasping may be generated by the discharge of 'pacemaker' neurons. In eupnea, this pacemaker activity is suppressed and incorporated into the pontile and medullary neuronal circuit responsible for the neurogenesis of eupnea. Evidence for ventilatory neurogenesis which has been obtained from a number of in vitro preparations is discussed. A much-used preparation is that of a 'superfused' brainstem of the neonatal rat. However, activities of this preparation differ greatly from those of eupnea, as recorded in vitro or in arterially perfused in vitro preparations. Activities of this 'superfused' preparation are identical with gasping and, hence, results must be reinterpreted accordingly. The possibility is present that mechanisms responsible for generating respiratory rhythms may differ from those responsible for shaping respiratory-modulated discharge patterns of cranial and spinal nerves. The importance of pontile mechanisms in the neurogenesis and control of eupnea is reemphasized.

Maternal cocaine alters eupneic ventilation but not gasping of neonatal rats

In severe hypoxia, normal eupneic respiration is replaced by gasping. Gasping provides for 'autoresuscitation' such that, if air is available, normal breathing returns. As maternal use of cocaine may increase the incidence of the Sudden Infant Death Syndrome (SIDS), prenatal exposure to cocaine was hypothesized to result in a failure of gasping in the newborn. Cocaine was administered daily to pregnant rats. In the newborn, no impairment of gasping as a mechanism of autoresuscitation was detected. However, on the first and second days after birth, ventilation in hypoxia was less in newborns having exposure to cocaine than in the control rats. Maternal use of cocaine may retard the development of the ventilatory control system. However, gasping mechanisms are not included in this retardation.