Welch Joseph F, Dale Erica A, Nair Jayakrishnan, Davenport Paul W, Fox Emily J, Mitchell Gordon S
School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.
Breathing Research and Therapeutics Center, Department of Physical Therapy, University of Florida, Gainesville, Florida, United States.
J Neurophysiol. 2025 Feb 1;133(2):522-529. doi: 10.1152/jn.00406.2024. Epub 2024 Dec 30.
We present a case report of a 42-year-old female with post-West Nile virus meningoencephalitis who exhibited unique, long-latency diaphragm potentials evoked by transcranial and cervical magnetic stimulation after exposure to acute intermittent hypoxia (AIH). The subject was recruited for a study investigating AIH effects on respiratory motor function in healthy individuals. She had contracted West Nile virus infection 5 years before assessment that resulted in hospitalization and persistent allodynia but was not reported to the research team. During the study, transcranial (TMS) and cervical (CMS) magnetic stimulation were performed before and 30-60 min after a single presentation of AIH [15, 1-min hypoxic episodes (∼9% inspired O), with 1-min normoxic intervals]. Diaphragm EMG was recorded using chest wall surface electrodes. At baseline, evoked diaphragm potentials were within normal ranges for both TMS (onset latency = 17.0 ± 1.1 ms; peak-to-peak amplitude = 220 ± 27 µV) and CMS (onset latency = 7.8 ± 0.6 ms; peak-to-peak amplitude = 336 ± 8 µV). However, long-latency TMS- and CMS-evoked potentials were observed 30-60 min post-AIH that were not present at baseline nor in healthy subjects. The onset of long-latency potentials ranged from 50 to 808 ms. While AIH is a potentially useful therapeutic strategy to enhance motor function after neurological disease or injury, it may elicit distinct effects in individuals with a history of neuroinfectious disease. Possible explanations for these unusual responses are discussed. A 42-year-old female with post-West Nile virus meningoencephalitis demonstrated long-latency diaphragmatic potentials evoked by transcranial and cervical magnetic stimulation following exposure to acute intermittent hypoxia that were not present at baseline nor in healthy subjects. Although the cause of long-latency responses is unknown, we discuss possible mechanisms whereby acute intermittent hypoxia could create unique effects on the diaphragm/phrenic motor system in individuals with a history of neuroinfectious disease.
我们报告了一例42岁女性西尼罗河病毒脑膜脑炎后遗症患者，该患者在经历急性间歇性缺氧（AIH）后，经颅和颈部磁刺激诱发了独特的、潜伏期较长的膈肌电位。该受试者被招募参加一项研究，该研究旨在调查AIH对健康个体呼吸运动功能的影响。在评估前5年，她感染了西尼罗河病毒，导致住院和持续性痛觉过敏，但未向研究团队报告。在研究过程中，在单次AIH（15次，每次1分钟的缺氧发作，吸入氧浓度约为9%，间隔1分钟的常氧期）之前和之后30 - 60分钟进行经颅磁刺激（TMS）和颈部磁刺激（CMS）。使用胸壁表面电极记录膈肌肌电图。在基线时，TMS（起始潜伏期 = 17.0 ± 1.1毫秒；峰峰值幅度 = 220 ± 27微伏）和CMS（起始潜伏期 = 7.8 ± 0.6毫秒；峰峰值幅度 = 336 ± 8微伏）诱发的膈肌电位均在正常范围内。然而，在AIH后30 - 60分钟观察到了基线时和健康受试者中均未出现的潜伏期较长的TMS和CMS诱发电位。潜伏期较长的电位起始时间在50至808毫秒之间。虽然AIH是增强神经疾病或损伤后运动功能的一种潜在有用的治疗策略，但它可能在有神经感染病史的个体中引发不同的效应。文中讨论了这些异常反应的可能解释。一名患有西尼罗河病毒脑膜脑炎后遗症的42岁女性在经历急性间歇性缺氧后，经颅和颈部磁刺激诱发了基线时和健康受试者中均未出现的潜伏期较长的膈肌电位。尽管潜伏期较长反应的原因尚不清楚，但我们讨论了急性间歇性缺氧可能对有神经感染病史的个体的膈肌/膈神经运动系统产生独特影响的可能机制。
