4.6 Article

Motor Unit Recruitment in Human Genioglossus Muscle in Response to Hypercapnia

Journal

SLEEP
Volume 33, Issue 11, Pages 1529-1538

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/sleep/33.11.1529

Keywords

Single motor unit; upper airway muscles; motor control; obstructive sleep apnea

Funding

  1. Ventus Medical
  2. Philips
  3. Pfizer
  4. Cephalon
  5. Sepracor
  6. Itamar
  7. NMT
  8. SGS
  9. Apnex
  10. Novartis
  11. Ethicon
  12. Medtronic
  13. [NHMRC-454458]
  14. [NIH-1R01HL085188-01A2]

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Study Objectives: Single motor unit recordings of the genioglossus (GG) muscle indicate that GO motor units have a variety of discharge patterns, including units that have higher discharge rates during inspiration (inspiratory phasic and inspiratory tonic), or expiration (expiratory phasic and expiratory tonic), or do not modify their rate with respiration (tonic). Previous studies have shown that an increase in GG muscle activity is a consequence of increased activity in inspiratory units. However, there are differences between studies as to whether this increase is primarily due to recruitment of new motor units (motor unit recruitment) or to increased discharge rate of already active units (rate coding). Sleep-wake state studies in humans have suggested the former, while hypercapnia experiments in rats have suggested the latter. In this study, we investigated the effect of hypercapnia on GG motor unit activity in humans during wakefulness. Setting: Sleep research laboratory. Participants: Sixteen healthy men. Measurements and Results: Each participant was administered at least 6 trials with PelCO2 being elevated 8.4 (SD = 1.96) mm Hg over 2 min following a 30-s baseline. Subjects were instrumented for GG EMG and respiratory measurements with 4 fine wire electrodes inserted subcutaneously into the muscle. One hundred forty-one motor units were identified during the baseline: 47% were inspiratory modulated, 29% expiratory modulated, and 24% showed no respiratory related modulation. Sixty-two new units were recruited during hypercapnia. The distribution of recruited units was significantly different from the baseline distribution, with 84% being inspiratory modulated (P < 0.001). Neither units active during baseline, nor new units recruited during hypercapnia, increased their discharge rate as PelCO2 increased (P > 0.05 for all comparisons). Conclusions: Increased GG muscle activity in humans occurs because of recruitment of previously inactive inspiratory modulated units.

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