COVID-19 patients often experience dyspnea due to several factors. The underlying unique pathophysiology of dyspnea in COVID-19 is not yet fully understood, but it is believed to be related to a combination of respiratory, cardiovascular, and neuromuscular factors. Hypoxemia is considered one of the key symptoms of COVID-19. This affects the respiratory drive, which determines the rate, depth, and pattern of breathing. The relationship between increased ventilatory neural drive and abnormal gas exchange, particularly in the context of ventilation/perfusion (V/Q) mismatches and chemosensitivity, has gained significant attention following the COVID-19 pandemic. The ACE2 receptors allow viral entry into the lungs, leading to the loss of surfactant, hypoxic vasoconstriction, and intrapulmonary shunting that may result in a V/Q mismatch. Additionally, acidosis, hypercapnia, elevated 2,3-diphosphogly-cerate levels and fever may shift the oxygen diffusion curve rightward, lowering arterial oxygen saturation levels and triggering ventilatory responses. This paper examines how physio pathological factors such as altered gas diffusion, chemosensory feedback, V/Q ratios, altered compliance, arterial blood gases, and respiratory muscle dysfunction in these patients affect ventilatory drive. A review of the published literature was also conducted to determine the mechanism of dyspnea. To ensure appropriate gas exchange, individuals need to augment their minute ventilation (VE) when physiological dead space is elevated. This serves as a compensatory mechanism to counteract the effects of compromised gas exchange and keep adequate oxygenation throughout the body. The respiratory centers may experience dysregulation due to the impact of the virus on the respiratory system, which could affect the rhythm-generating and pattern-generating signals that are vital for regulating the respiratory rate and depth of breathing effort. The cerebral cortex, in conjunction with the brain stem centers, plays a crucial role in regulating ventilation during prolonged hypoxemia. This interaction between these two components may help elucidate the conscious respiratory sensation (or dyspnea) experienced by patients. It is hypothesized that neuroventilatory decoupling acts as a mechanism to prevent sensory signals from translating into mechanical or ventilatory responses. This decoupling phenomenon is believed to have a notable impact on the intensity of breathlessness. By understanding the relationship between increased ventilatory neural drive and abnormal gas exchange, particularly in the context of ventilation/perfusion (V/Q) mismatches and altered chemosensitivity, healthcare professionals can develop strategies to optimize respiratory support for COVID-19 patients.
{"title":"Modulation of Respiratory Neural Drive by Physiological Loads in COVID-19 Patients with Dyspnea","authors":"Maxim Crasta, Zainab Alam, Shamil Lakhani","doi":"10.4236/nm.2023.143003","DOIUrl":"https://doi.org/10.4236/nm.2023.143003","url":null,"abstract":"COVID-19 patients often experience dyspnea due to several factors. The underlying unique pathophysiology of dyspnea in COVID-19 is not yet fully understood, but it is believed to be related to a combination of respiratory, cardiovascular, and neuromuscular factors. Hypoxemia is considered one of the key symptoms of COVID-19. This affects the respiratory drive, which determines the rate, depth, and pattern of breathing. The relationship between increased ventilatory neural drive and abnormal gas exchange, particularly in the context of ventilation/perfusion (V/Q) mismatches and chemosensitivity, has gained significant attention following the COVID-19 pandemic. The ACE2 receptors allow viral entry into the lungs, leading to the loss of surfactant, hypoxic vasoconstriction, and intrapulmonary shunting that may result in a V/Q mismatch. Additionally, acidosis, hypercapnia, elevated 2,3-diphosphogly-cerate levels and fever may shift the oxygen diffusion curve rightward, lowering arterial oxygen saturation levels and triggering ventilatory responses. This paper examines how physio pathological factors such as altered gas diffusion, chemosensory feedback, V/Q ratios, altered compliance, arterial blood gases, and respiratory muscle dysfunction in these patients affect ventilatory drive. A review of the published literature was also conducted to determine the mechanism of dyspnea. To ensure appropriate gas exchange, individuals need to augment their minute ventilation (VE) when physiological dead space is elevated. This serves as a compensatory mechanism to counteract the effects of compromised gas exchange and keep adequate oxygenation throughout the body. The respiratory centers may experience dysregulation due to the impact of the virus on the respiratory system, which could affect the rhythm-generating and pattern-generating signals that are vital for regulating the respiratory rate and depth of breathing effort. The cerebral cortex, in conjunction with the brain stem centers, plays a crucial role in regulating ventilation during prolonged hypoxemia. This interaction between these two components may help elucidate the conscious respiratory sensation (or dyspnea) experienced by patients. It is hypothesized that neuroventilatory decoupling acts as a mechanism to prevent sensory signals from translating into mechanical or ventilatory responses. This decoupling phenomenon is believed to have a notable impact on the intensity of breathlessness. By understanding the relationship between increased ventilatory neural drive and abnormal gas exchange, particularly in the context of ventilation/perfusion (V/Q) mismatches and altered chemosensitivity, healthcare professionals can develop strategies to optimize respiratory support for COVID-19 patients.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"53 83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135401835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Sleep is critical to human physiological function, cognitive performance, and emotional regulation. Healthcare personnel, especially physicians, are chronically exposed to long working hours, which are often accompanied by decreased sleep time. Clinical evidence indicates that these conditions affect their cognitive function and professional practice, but researchers in the field have not sufficiently explored the possible effects of reductions in sleep time on social cognition. Objective: The aim of this is to further explore the effects of sleep restriction among medical residents, the specific impairments in social cognition that it produces, and the effects of a sleep hygiene orientation on those impairments. Method: There were 124 medical residents (50 males, 74 females) who completed a daily sleep/work log, a battery of sleep tests/questionnaires, and neuropsychological evaluations. The participants then received a short course (8 hours) on basic concepts of sleep hygiene and sleep psychoeducation. Once the course was completed, participants filled out the questionnaires again. Results: The results indicate that sleep disturbances in medical residents were associated with severe neurocognitive and social cognition impairments. After the sleep hygiene intervention, neuropsychological function and sleep parameters improved, awareness increased, and social cognition performance significantly improved. Conclusion: Using sleep psychoeducation and sleep hygiene intervention in medical residents is a simple strategy to mitigate the effects of sleep restriction.
{"title":"Effect of Sleep Hygiene Orientation on Social Cognition Impairments Due to Chronic Sleep Restriction in Mexican Medical Residents","authors":"Jiménez-Ceballos Betsabe, Arana-Lechuga Debora Yoaly, Terán-Pérez Guadalupe Jovanna, Escartín-Pérez Rodrigo Erick, Velázquez-Moctezuma Javier","doi":"10.4236/nm.2023.143004","DOIUrl":"https://doi.org/10.4236/nm.2023.143004","url":null,"abstract":"Introduction: Sleep is critical to human physiological function, cognitive performance, and emotional regulation. Healthcare personnel, especially physicians, are chronically exposed to long working hours, which are often accompanied by decreased sleep time. Clinical evidence indicates that these conditions affect their cognitive function and professional practice, but researchers in the field have not sufficiently explored the possible effects of reductions in sleep time on social cognition. Objective: The aim of this is to further explore the effects of sleep restriction among medical residents, the specific impairments in social cognition that it produces, and the effects of a sleep hygiene orientation on those impairments. Method: There were 124 medical residents (50 males, 74 females) who completed a daily sleep/work log, a battery of sleep tests/questionnaires, and neuropsychological evaluations. The participants then received a short course (8 hours) on basic concepts of sleep hygiene and sleep psychoeducation. Once the course was completed, participants filled out the questionnaires again. Results: The results indicate that sleep disturbances in medical residents were associated with severe neurocognitive and social cognition impairments. After the sleep hygiene intervention, neuropsychological function and sleep parameters improved, awareness increased, and social cognition performance significantly improved. Conclusion: Using sleep psychoeducation and sleep hygiene intervention in medical residents is a simple strategy to mitigate the effects of sleep restriction.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"267 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135401513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Basse, Khalifa Ababacar Mbaye, A. Sow, R. Diagne, A. Mbodji, Mame Doyneck Dieng, M. Ndong, M. Ndiaye
{"title":"Guillain-Barré Syndrome (GBS) in Children, the Experience of Senegal","authors":"A. Basse, Khalifa Ababacar Mbaye, A. Sow, R. Diagne, A. Mbodji, Mame Doyneck Dieng, M. Ndong, M. Ndiaye","doi":"10.4236/nm.2023.141001","DOIUrl":"https://doi.org/10.4236/nm.2023.141001","url":null,"abstract":"","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78327125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Diatewa, Inès Frédérique Nsondé-Mondzié, Dinah Happhia Boubayi Motoula-Latou, Eliot Prince Galiéni Sounga-Banzouzi, Y. Kaba, G. Mpandzou, P. Ossou-Nguiet
{"title":"Knowledge about the Management of Anti-Epileptic Drug Treatment among General Practitioners in Brazzaville, Congo","authors":"J. Diatewa, Inès Frédérique Nsondé-Mondzié, Dinah Happhia Boubayi Motoula-Latou, Eliot Prince Galiéni Sounga-Banzouzi, Y. Kaba, G. Mpandzou, P. Ossou-Nguiet","doi":"10.4236/nm.2023.142002","DOIUrl":"https://doi.org/10.4236/nm.2023.142002","url":null,"abstract":"","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84628917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khalifa Ababacar Mbaye, K. Diallo, R. Diagne, M. Ndiaye, A. Diop, N. Manga
{"title":"Stroke and Covid-19: The Experience of the Ziguinchor/Senegal Epidemic Treatment Center","authors":"Khalifa Ababacar Mbaye, K. Diallo, R. Diagne, M. Ndiaye, A. Diop, N. Manga","doi":"10.4236/nm.2022.133009","DOIUrl":"https://doi.org/10.4236/nm.2022.133009","url":null,"abstract":"","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77043728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Yumatov, E. Dudnik, O. Glazachev, A.I. Filipchenko, S. Pertsov
{"title":"Revealing True and False Brain States Based on Wavelet Analysis of Electroencephalogram","authors":"E. Yumatov, E. Dudnik, O. Glazachev, A.I. Filipchenko, S. Pertsov","doi":"10.4236/nm.2022.132006","DOIUrl":"https://doi.org/10.4236/nm.2022.132006","url":null,"abstract":"","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"59 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83415268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Gaye, A. Diop, Khalifa Ababacar Mbaye, S. Fall, M. Ka, M. Ndiaye, M. Fall, M. Ndiaye, A. Diop
{"title":"Peripheral Neuropathies Revealing Gougerot-Sjögren’s Syndrome: Description of 3 Cases","authors":"N. Gaye, A. Diop, Khalifa Ababacar Mbaye, S. Fall, M. Ka, M. Ndiaye, M. Fall, M. Ndiaye, A. Diop","doi":"10.4236/nm.2022.133011","DOIUrl":"https://doi.org/10.4236/nm.2022.133011","url":null,"abstract":"","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75286840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Awareness of Hail Region Population about Facial Nerve Palsy (Seventh Cranial Nerve Palsy)","authors":"Ghorashy Eltayeb Yousif, TurkiAli Alshammari, Hamoud Abdelkarim Almarshadi","doi":"10.4236/nm.2022.133010","DOIUrl":"https://doi.org/10.4236/nm.2022.133010","url":null,"abstract":"","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90962550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Short-Term and Medium-Term Prognosis of a Stroke and the Factors of Poor Prognosis in Liberville","authors":"Nyangui Mapaga Jennifer, Gningone Pupchen Marylise, Mambila Grass Aurelle, Diouf Mbourou Nelly, Saphou-Damon Michel-Arnaud, Nsounda Annick Andréa, Camara Ibrahima, Kouna-Ndouongo Philomène","doi":"10.4236/nm.2022.134013","DOIUrl":"https://doi.org/10.4236/nm.2022.134013","url":null,"abstract":"","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"296 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77914011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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