Abstract：
Degenerative cervical myelopathy (DCM) is a debilitating neurological condition characterized by chronic compression of the cervical spinal cord leading to impaired upper and lower limb function. Despite damage to areas of the cervical spinal cord that house the respiratory network, respiratory dysfunction is not a common symptom of DCM. However, DCM may be associated with respiratory dysfunction, and this can affect the ventilatory response to respiratory challenges during emergence from anesthesia, exercise, or pulmonary disease. Surgical spinal cord decompression, which is the primary treatment for DCM, leads to improved sensorimotor function in DCM; yet its impact on respiratory function is unknown. Here, using a clinically relevant model of DCM, we evaluate respiratory function during disease progression and assess adaptive ventilation to hypercapnic challenge before and after surgical intervention. We show that despite significant and progressive forelimb and locomotor deficits, there was no significant decline in eupneic ventilation from the early to late phases of spinal cord compression. Additionally, for the first time, we demonstrate that despite normal ventilation under resting conditions, DCM impairs acute adaptive ventilatory ability in response to hypercapnia. Remarkably, akin to DCM patients, surgical decompression treatment improved sensorimotor function in a subset of mice. In contrast, none of the mice that underwent surgical decompression recovered their ability to respond to hypercapnic ventilatory challenge. These findings underscore the impact of chronic spinal cord compression on respiratory function, highlighting the challenges associated with ventilatory response to respiratory challenges in individuals with DCM. This research highlights the impact of cervical spinal cord compression on respiratory dysfunction in DCM, as well as the persistence of adaptive ventilatory dysfunction after surgical spinal cord decompression. These results indicate the need for additional interventions to enhance recovery of respiratory function after surgery for DCM.
摘要：
退行性颈椎病（DCM）是一种使人衰弱的神经系统疾病，其特征是颈脊髓的慢性压迫导致上肢和下肢功能受损。尽管颈脊髓的呼吸网络受损，呼吸功能障碍不是DCM的常见症状。然而,DCM可能与呼吸功能障碍有关，这可能会影响麻醉出现时对呼吸挑战的通气反应，锻炼,或肺部疾病。手术脊髓减压术,这是DCM的主要治疗方法，改善DCM的感觉运动功能；但其对呼吸功能的影响尚不清楚。这里,使用临床相关的DCM模型，我们评估疾病进展期间的呼吸功能,并评估手术干预前后对高碳酸血症挑战的适应性通气.我们表明，尽管前肢和运动障碍显著和进行性，从脊髓压迫的早期到晚期，eupneic通气没有显着下降。此外,第一次,我们证明，尽管在休息条件下通风正常，DCM对高碳酸血症的急性适应性通气能力受损。值得注意的是,类似于DCM患者，手术减压治疗改善了一部分小鼠的感觉运动功能。相比之下,接受手术减压的小鼠均未恢复对高碳酸血症通气挑战的反应能力。这些发现强调了慢性脊髓压迫对呼吸功能的影响，强调了与DCM患者对呼吸挑战的通气反应相关的挑战。这项研究强调了颈脊髓压迫对DCM呼吸功能障碍的影响，以及手术脊髓减压后适应性通气功能障碍的持续存在。这些结果表明需要额外的干预措施以增强DCM手术后呼吸功能的恢复。
