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Am. J. Respir. Crit. Care Med., Volume 161, Number 6, June 2000, 1830-1835

Respiratory-related Evoked Potentials in Children with Life-threatening Asthma

PAUL W. DAVENPORT, MAURICE CRUZ,* ARLENE A. STECENKO,dagger and YEMISERACH KIFLEDagger

Departments of Pediatrics and Physiological Sciences, University of Florida, Gainesville, Florida

Respiratory-related evoked potentials (RREPs) have been elicited by inspiratory occlusion and recorded over the somatosensory cortex. The first positive peak (P1) amplitude has been correlated with the magnitude of inspiratory loads. Since children with life-threatening asthma (LTA) have a decreased perceptual sensitivity of inspiratory loads, we hypothesized that a subpopulation of patients with LTA have an impaired ability to sense mechanical loads, and that these patients would have an abnormal RREP. The RREP was recorded from CZ -C3 and CZ -C4 in three groups: LTA asthmatic, control asthmatic, and nonasthmatic children. Two inspiratory-interruption occlusions trials and a control trial were recorded. All the evoked potentials were analyzed after the averaged control trial was subtracted from the averaged occlusion trials. The RREP P1 peak was observed in all 14 nonasthmatic children and in 14 of 15 control asthmatic children. The RREP was absent in 6 of 11 patients with LTA. When present, there were no between-group significant differences in P1 peak latency or amplitude. These results demonstrate that the RREP elicited by inspiratory occlusion is present bilaterally in nonasthmatic and asthmatic children. There is a subpopulation of LTA children in which inspiratory occlusion fails to elicit the P1 peak of the RREP, suggesting an altered neural processing of inspiratory load information.




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