Plasticity in the brain: influence of bilateral carotid body resection (bCBR) on central CO2 sensitivity.
We investigated the effect of bilateral carotid body resection (bCBR) in a patient with bilateral carotid body tumors on central CO2 sensitivity. We applied multiple square-wave changes in end-tidal CO2 and measured ventilation before the first surgery and at regular intervals for 3 years after surgery. The data were analyzed using a two-compartment model of the ventilatory control system. bCBR resulted in the loss of the fast response to CO2, and a sharp reduction in the magnitude of central CO2 sensitivity (a reduction of about 80% within 3 months after bCBR). Central CO2 sensitivity gradually increased to pre-operative values within 2 years after surgery. These observations are a strong indication for (1) the existence of a tonic influence from the peripheral chemoreceptors of the carotid bodies on central CO2 drive; (2) absence of any recovery of the peripheral drive after bCBR; and (3) neural plasticity causing the regeneration of central drive after bCBR.
Dahan
Albert
A
Leiden University Medical Center, Department of Anesthesiology, 2300 RC Leiden, The Netherlands. a.dahan@lumc.nl
Sarton
Elise
E
Teppema
Luc
L
D001794:Blood Pressure; D001921:Brain / Q000502:physiology*; D002245:Carbon Dioxide / Q000502:physiology*; D002344:Carotid Body / Q000502:physiology* / Q000601:surgery; D015687:Cell Hypoxia; D007839:Functional Laterality; D006706:Homeostasis; D006801:Humans; D009473:Neuronal Plasticity; D012143:Respiratory Physiological Phenomena
D002245:Carbon Dioxide