Respiration is controlled voluntari

Respiration is controlled voluntarily and involuntarily through the motor and premotor cortex, brainstem, and cervical phrenic nucleus and nerve, involving sensors and autonomic system as well.7 It is not clear how DBS controls respiratory dyskinesia, though it most likely involves stimulating the basal ganglia loop (as it does for limb/trunk dyskinesia) and possibly the thalamic-hypothalamic connections and hypothalamic autonomic system as well, thus influencing both voluntary and involuntary respiration.6,7 It is not clear why only the respiratory muscles were involved. We did not perform the needle EMG study to characterize the underlying physiology for fear of complications, such as pneumothorax due to the perforation of the needle through the diaphragm during dyskinesia.This case will help manage this probably underrecognized and undertreated respiratory dyskinesia in patients with<br>PD in the future.

呼吸是通过运动和运动前皮质、脑干、颈部膈核和神经自愿和非自愿控制的，包括传感器和自主神经系统。7目前尚不清楚DBS是如何控制呼吸运动障碍的，尽管它很可能涉及刺激基底节环（就像对肢体/躯干运动障碍所做的那样），以及丘脑-下丘脑连接和下丘脑自主神经系统，从而影响自主呼吸和非自主呼吸。6,7不清楚为什么只涉及呼吸肌。我们没有进行针头肌电图研究来描述潜在的生理特征，因为担心并发症，例如运动障碍期间针头穿过横膈膜导致气胸。本病例将有助于治疗患有呼吸系统疾病的患者中可能未得到充分认识和治疗的呼吸运动障碍<br>未来的PD。

呼吸通过运动和运动前皮层、脑干、颈膈核和神经，以及传感器和自主系统受到自主和非自主控制。7目前尚不清楚DBS如何控制呼吸运动障碍，尽管它很可能涉及刺激基底神经节环(正如它对肢体/躯干运动障碍的作用)，也可能涉及丘脑-下丘脑连接和下丘脑自主系统，从而影响自主和非自主呼吸。6，7尚不清楚为什么只有呼吸肌参与。我们没有进行针刺肌电图研究来描述潜在的生理学特征，因为害怕并发症，例如在运动障碍时针刺穿膈肌引起的气胸。这个案例将有助于管理这种可能认识不足和治疗不足的呼吸运动障碍患者未来的PD。