Drawing breath without the command of effectors: The control of respiration following spinal cord injury

Philippa M. Warren, Basem I. Awad, Warren J. Alilain

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


The maintenance of blood gas and pH homeostasis is essential to life. As such breathing, and the mechanisms which control ventilation, must be tightly regulated yet highly plastic and dynamic. However, injury to the spinal cord prevents the medullary areas which control respiration from connecting to respiratory effectors and feedback mechanisms below the level of the lesion. This trauma typically leads to severe and permanent functional deficits in the respiratory motor system. However, endogenous mechanisms of plasticity occur following spinal cord injury to facilitate respiration and help recover pulmonary ventilation. These mechanisms include the activation of spared or latent pathways, endogenous sprouting or synaptogenesis, and the possible formation of new respiratory control centres. Acting in combination, these processes provide a means to facilitate respiratory support following spinal cord trauma. However, they are by no means sufficient to return pulmonary function to pre-injury levels. A major challenge in the study of spinal cord injury is to understand and enhance the systems of endogenous plasticity which arise to facilitate respiration to mediate effective treatments for pulmonary dysfunction.

Original languageEnglish
Pages (from-to)98-108
Number of pages11
JournalRespiratory Physiology and Neurobiology
StatePublished - Nov 1 2014

Bibliographical note

Funding Information:
This work was supported by funding from the International Spinal Research Trust ( STR117 ), Wings for Life ( WFL_US_027/14 ), the Craig H. Neilsen Foundation ( 221988 ), and MetroHealth Medical Center , Cleveland, Ohio, USA. The authors acknowledge and wish to thank Profs. Paul Davenport and Eugene Nalivaiko for their kind invitation to submit a manuscript and their support.

Publisher Copyright:
© 2014 Elsevier B.V.

Copyright 2014 Elsevier B.V., All rights reserved.

ASJC Scopus subject areas

  • Neuroscience (all)
  • Physiology
  • Pulmonary and Respiratory Medicine


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