Kukwa A, Gromysz H, Jernajczyk U, Karczewski W A
Department of Neurophysiology, Polish Academy of Sciences, Medical Research Centre, Warsaw.
Acta Physiol Pol. 1989 Sep-Dec;40(5-6):473-8.
Several observations indicate that the mylohyoid nerve (NV) may play a crucial part in the mechanisms of obstructive sleep apnea (OSA). The activity of this nerve normally counteracts the collapse of the upper airways during inspiration. Any reduction in this activity may thus facilitate the occurrence of apnoeic spells. We have studied the effects of ethanol and lung inflations on the activity of NV recorded along with the activities of phrenic and facial nerve in rabbits anaesthetised with chloralose-urethan, paralyzed with curare and artificially ventilated. Under the control conditions the NV exhibited phasic expiratory activity; after vagotomy and additional, inspiratory component was observed. Lung inflation strongly enhanced the expiratory activity of NV whereas both the phrenic and facial nerve activities (both phasic-inspiratory) were typically inhibited. An injection of 5 ml of 20% ethanol very strongly inhibited the NV activity. The results may confirm the importance of NV in the mechanism of OSA. The well-known fact that OSA patients are particularly sensitive to alcohol finds support in the response of NV activity to ethanol injection. The analysis of the patterns of discharges of the three outputs from the respiratory controller may additionally suggest that the Vth nerve nucleus is involved in the control of respiratory pattern.
多项观察结果表明，下颌舌骨肌神经（NV）可能在阻塞性睡眠呼吸暂停（OSA）的发病机制中起关键作用。该神经的活动通常可抵消吸气过程中上呼吸道的塌陷。因此，该神经活动的任何降低都可能促使呼吸暂停发作的发生。我们研究了乙醇和肺充气对NV活动的影响，同时记录了用氯醛糖-乌拉坦麻醉、箭毒麻痹并进行人工通气的家兔的膈神经和面神经活动。在对照条件下，NV表现出阶段性呼气活动；迷走神经切断术后，观察到了额外的吸气成分。肺充气强烈增强了NV的呼气活动，而膈神经和面神经活动（均为阶段性吸气活动）则通常受到抑制。注射5毫升20%的乙醇非常强烈地抑制了NV活动。这些结果可能证实了NV在OSA发病机制中的重要性。OSA患者对酒精特别敏感这一众所周知的事实，在NV活动对乙醇注射的反应中得到了支持。对呼吸控制器三个输出的放电模式的分析可能还表明，三叉神经核参与了呼吸模式的控制。
