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November 1960

Neural Mechanisms of Abnormal Respiration in Humans

Arch Neurol. 1960;3(5):484-487. doi:10.1001/archneur.1960.00450050004002

Since Legallois1 discovered that restricted medullary lesions halted breathing. experimental studies on mammalian respiratory control have concentrated on determining how more or less localized brain stem regions modify respiration. From these studies has arisen the concept of a hierarchy of brain stem respiratory "centers," located in upper pons, lower pons, and medulla.2-4 In the upper pons, the pneumotaxic center has been operationally defined as that area which, together with afferent vagus nerve influences, inhibits sustained inspiration and permits rhythmic breathing. In the lower pons is a region which, when unopposed, stimulates prolonged inspiratory cramps (apneusis). Separate medullary inspiratory and expiratory centers have been identified both by noting maximal responses to discrete stimuli4,5 and, more recently, by exploring with microelectrodes.6-9

Throughout the period of the above work, comparatively less emphasis was devoted to the pathological physiology responsible for disordered respiratory control in man. As a result, it

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