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      The Influence of Breathing on the Central Nervous System

      review-article
      1 , , 2 , 3 , 4 , 5
      ,
      Cureus
      Cureus
      diaphragm, breathing, phrenic nerve, vagus nerve, neural oscillation

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          Abstract

          The functions of the diaphragm do not stop locally in its anatomy but affect the whole body system. The respiratory rhythm, directly and indirectly, affects the central nervous system (CNS). This article describes and reviews these influences, containing, for the first time, information on this subject in a single text. The ability of breath to move the brain mass and determine patterns of neural oscillation will be discussed. The role of the diaphragm in influencing motor expression and its effect on intracranial blood shifts in respiratory activity will also be discussed. It is known that the diaphragm can have multiple uses in improving the symptomatological picture of chronic diseases, but there is no current, concrete data on the effects that the rehabilitative training or manual approaches could have on the patient; in particular, on his/her cognitive and cerebral aspects in general.

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          Most cited references48

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          Understanding the rhythm of breathing: so near, yet so far.

          Breathing is an essential behavior that presents a unique opportunity to understand how the nervous system functions normally, how it balances inherent robustness with a highly regulated lability, how it adapts to both rapidly and slowly changing conditions, and how particular dysfunctions result in disease. We focus on recent advancements related to two essential sites for respiratory rhythmogenesis: (a) the preBötzinger Complex (preBötC) as the site for the generation of inspiratory rhythm and (b) the retrotrapezoid nucleus/parafacial respiratory group (RTN/pFRG) as the site for the generation of active expiration.
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            Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part I.

            The vagus nerve (VN), the "great wondering protector" of the body, comprises an intricate neuro-endocrine-immune network that maintains homeostasis. With reciprocal neural connections to multiple brain regions, the VN serves as a control center that integrates interoceptive information and responds with appropriate adaptive modulatory feedbacks. While most VN fibers are unmyelinated C-fibers from the visceral organs, myelinated A- and B-fiber play an important role in somatic sensory, motor, and parasympathetic innervation. VN fibers are primarily cholinergic but other noncholinergic nonadrenergic neurotransmitters are also involved. VN has four vagal nuclei that provide critical controls to the cardiovascular, respiratory, and alimentary systems. Latest studies revealed that VN is also involved in inflammation, mood, and pain regulation, all of which can be potentially modulated by vagus nerve stimulation (VNS). With a broad vagal neural network, VNS may exert a neuromodulatory effect to activate certain innate "protective" pathways for restoring health.
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              Vagus Nerve Stimulation.

              The vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation. Left cervical VNS is an approved therapy for refractory epilepsy and for treatment resistant depression. Right cervical VNS is effective for treating heart failure in preclinical studies and a phase II clinical trial. The effectiveness of various forms of non-invasive transcutaneous VNS for epilepsy, depression, primary headaches, and other conditions has not been investigated beyond small pilot studies. The relationship between depression, inflammation, metabolic syndrome, and heart disease might be mediated by the vagus nerve. VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiological biomarkers associated with depression morbidity and mortality.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                1 June 2018
                June 2018
                : 10
                : 6
                : e2724
                Affiliations
                [1 ] Cardiology, Foundation Don Carlo Gnocchi Irccs, Department of Cardiology, Institute of Hospitalization and Care, Milano, ITA
                [2 ] Osteopathy, National University of Medical Sciences (usa), Naples, USA
                [3 ] Osteopathy, CRESO, School of Osteopathic Centre for Research and Studies, Fano, ITA
                [4 ] Department of Cardiology, Foundation Don Carlo Gnocchi Irccs, Department of Cardiology, Institute of Hospitalization and Care, Milano, ITA
                [5 ] Osteopathy, School of Osteopathic Centre for Research and Studies, Rome, ITA
                Author notes
                Article
                10.7759/cureus.2724
                6070065
                30083485
                631b7363-34de-4ed9-a262-0114566d6826
                Copyright © 2018, Bordoni et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 24 May 2018
                : 1 June 2018
                Categories
                Physical Medicine & Rehabilitation
                Other

                diaphragm,breathing,phrenic nerve,vagus nerve,neural oscillation

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