• Respir Physiol Neurobiol · Apr 2011

    Cartography of human diaphragmatic innervation: preliminary data.

    • Eric Verin, Jean-Paul Marie, and Thomas Similowski.
    • Rouen University Hospital, Department of Physiology, 76031 Rouen Cedex, France. eric.verin@chu-rouen.fr
    • Respir Physiol Neurobiol. 2011 Apr 30;176(1-2):68-71.

    AbstractIn humans, anatomy indicates that the phrenic nerve mainly arises from the C4 cervical root, with variable C3 and C5 contributions. How this translates into functional innervation is unknown. The diaphragm response to electrical stimulation of C3, C4 and C5 was described in three patients undergoing surgical laryngeal reinnervation with an upper phrenic root (surface chest electrodes at anterior, lateral and posterior sites; oesophageal and gastric pressures (Pes and Pga) to derive transdiaphragmatic pressure (Pdi)). Anatomically, the phrenic nerve predominantly originated from C4. Phrenic stimulation elicited motor responses at the three sites in the three patients, as did C4 stimulation. It produced Pdi values of 9, 11, and 14cmH(2)O in the three patients, respectively, vs. 9, 9, and 7cmH(2)O for C4. C3 stimulation produced modest Pdi responses, whereas C5 stimulation could produce Pdi responses close to those observed with C4 stimulation. These singular observations confirm the dominance of C4 in diaphragm innervation but suggest than C5 can be of importance.Copyright © 2010 Elsevier B.V. All rights reserved.

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