Elicitation Of Reflex Research Articles

Bedside electromyography for clinical assessment of sacral motor and reflex activity adapted for patients hospitalized with acute neurological conditions: a pilot study.

Pilot cohort study. To develop and implement a sacral electromyographic (sEMG) technique at bedside to ascertain sparing of sacral motor activity and reflexes in patients hospitalized for acute neurological conditions. Hôpital du Sacré-Coeur de Montréal a Canadian Level-1 university trauma center specialized in SCI care. Nine patients underwent digital rectal examination (DRE) and sEMG, assessing voluntary anal contraction and sacral spinal reflexes (bulbocavernosus reflex and the anal wink). Our sEMG technique utilized surface recording electrodes and tactile elicitation of reflexes. EMG signal was acquired at bedside through the Noraxon MR3 system. It was quick, well accepted and did no harm. We found that contrary to the DRE, sEMG detected subclinical sacral motor activity and reflexes in 20% of cases for voluntary anal contraction and 40% of cases for the anal wink. We believe our sEMG technique is a powerful tool able to enhance management of patients suffering from acute neurological impairments and requiring sacral function assessment.

The feasibility and technical aspects of trigemino-cervical reflex elicitation in humans under general anesthesia

ObjectiveTo analyze the feasibility, neurophysiological aspects, stimulation patterns, and topographic distribution of trigemino-cervical reflex (TCR) components in humans under general anesthesia. MethodsThis prospective observational study enrolled 20 participants who underwent posterior fossa surgery, surgical proceduresin thecraniovertebral junction,or spinal cord surgery. TCR responses were simultaneously recorded in the sternocleidomastoid (SCM) and trapezius muscles after electrical stimulation of the supraorbital and infraorbital nerves. TCR responses were recorded preoperatively and intraoperatively using single-pulse and multipulse (trains of 2–7 electrical stimuli) stimulation, respectively. Two stimulus duration patterns were evaluated: 0.2–0.5 ms and 0.5–1.0 ms. ResultsIntraoperatively, short- and long-latency TCR components were obtained in the SCM ipsilateral to the stimulation with variable recordability. Short-latency responses were the most commonly recorded components. A longer stimulus duration (0.5–1.0 ms) seems to favor the elicitation of TCR responses under general anesthesia. ConclusionsShort-latency components recorded in the SCM ipsilateral to the stimulation could be regularly elicited under general anesthesia when a larger stimulus duration (0.5–1.0 ms) was applied. SignificanceThis is the first study to demonstrate the elicitation of TCR components in humans under general anesthesia. This neurophysiological technique can potentially optimize intraoperative neurophysiological monitoring during brainstem surgery.

Assessment of Laryngeal Sensory Function using a Tactile Aesthesiometer in Healthy Adults.

Laryngeal sensory function in healthy adults was assessed through the delivery of tactile stimuli using Cheung-Bearelly monofilaments. 37 healthy adults were recruited with 340 tactile stimuli analyzed. Four calibrated tactile stimuli were delivered to three laryngeal sites: false vocal fold (FVF), aryepiglottic fold (AEF), and lateral pyriform sinus (LPS). Primary outcome was the elicitation of laryngeal adductor reflex (LAR). Secondary outcomes were gag, patient-reported laryngeal sensation (PRLS), and perceptual strength. Analysis was performed with mixed effects logistic regression modeling. Positive LAR was observed in 35.7%, 70.2%, and 91.2% of stimuli at LPS, AEF, and FVF respectively. LAR rates were significantly associated with laryngopharyngeal subsite (p< 0.001), tactile force (p= 0.001), age (p= 0.022) and sex (p= 0.022). LAR, gag, PRLS, and perceptual strength significantly increased as a more medial laryngeal subsite was stimulated and as stimulus force increased. Each of the ten years of age increase was associated with 19% reduction in odds of LAR (aOR=0.81, 95% CI [0.68, 0.97]; p= 0.022). Male gender was associated with a 55% reduction in odds of LAR (aOR=0.45, 95% CI [0.23, 0.89]; p= 0.022). LAR elicitation capability decreases in the male gender, aging, and a more lateral subsite. This study provides insight into the pathophysiology of hypo- and hyper-sensitive laryngeal disorders and is paramount to making accurate diagnostic assessments and finding novel treatment options for various laryngological disorders. Laryngoscope, 133:2525-2532, 2023.

Intraoperative Pulseless Electrical Activity Cardiac Arrest during Intracranial Aneurysm Clipping: Case Report

Cardiac arrest is a rare intraoperative complication with few cases reported during neurosurgery. Proposed causes of PEA cardiac arrest in this setting include medications, irrigation, coronary vasospasm, and elicitation of the trigeminocardiac reflex.

Assessment of Different Technique of Eliciting the Planter Reflex in Term Neonates

Background: Planter reflex is still an essential part of the neurological examination. The usual plantar reflex involved bending of the big toe or no response. There is a positive Babinski signal with corticospinal dysfunction, which involves big toe dorsal flexion and the accompanying fanning of the other toes. It’s one of the infant reflexes that disappers as the infant nervous system grows. The plantar reaction is primarily extensive in stable, term neonates. Many have researched this reflex's accuracy but very few studies have analyzed the various techniques of the planting reflex.&#x0D; Objective: To assess the five different technique of eliciting the plantar reflex in newborn babies.&#x0D; Materials and Methods: In this cross-sectional study, the eligible healthy newborn will be given the different methods for the elicitation of the plantar reflex i.e. Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign. During this procedure, we will record the baseline RR, HR, and SpO2 before, and after the procedure. Three pediatric residents of the different years will be selected for examining the newborn reflexes throughout the study period.&#x0D; Results: After completion of the study, we will come to know the negative likelihood ratio, negative predictive value, positive predictive, specificity, positive likelihood ratio, and sensitivity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign.&#x0D; Conclusion: The study will probably give us information about the sensitivity and specificity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign for the elicitation of the plantar reflex in the neonates.

A Smart Tendon Hammer System for Remote Neurological Examination

The deep tendon reflex exam is an important part of neurological assessment of patients consisting of two components, reflex elicitation and reflex grading. While this exam has traditionally been performed in person, with trained clinicians both eliciting and grading the reflex, this work seeks to enable the exam by novices. The COVID-19 pandemic has motivated greater utilization of telemedicine and other remote healthcare delivery tools. A smart tendon hammer capable of streaming acceleration measurements wirelessly allows differentiation of correct and incorrect tapping locations with 91.5% accuracy to provide feedback to users about the appropriateness of stimulation, enabling reflex elicitation by laypeople, while survey results demonstrate that novices are reasonably able to grade reflex responses. Novice reflex grading demonstrates adequate performance with a mean error of 0.2 points on a five point scale. This work shows that by assisting in the reflex elicitation component of the reflex exam via a smart hammer and feedback application, novices should be able to complete the reflex exam remotely, filling a critical gap in neurological care during the COVID-19 pandemic.

The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue.

This study investigated the cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia using the spontaneous sequence method. Systolic blood pressure (SBP), interbeat interval (IBI), stroke volume (SV), pre-ejection period (PEP), and total peripheral resistance (TPR) were continuously recorded in 40 fibromyalgia patients and 30 healthy individuals during a cold pressor test and a mental arithmetic task. Sequences of covariation between SBP and IBI (cardiac branch), SV and PEP (myocardial branch), and TPR (vasomotor branch) were identified. Baroreflex sensitivity (BRS) was represented by the slope of the regression line between values in the sequences; baroreflex effectiveness (BEI) was indexed by the proportion of progressive SBP changes that elicited reflex responses. Patients exhibited lower BRS in the three branches, lower BEI in the cardiac and vasomotor branches, and reduced reactivity in cardiac BRS and BEI, SBP, IBI, SV, and PEP. Moreover, BRS and BEI were inversely related to clinical pain, cold pressor pain, depression, trait anxiety, sleep problems, and fatigue. Reduced function of the three baroreflex branches implies diminished resources for autonomic inotropic, chronotropic, and vascular regulation in fibromyalgia. Blunted stress reactivity indicates a limited capacity for autonomic cardiovascular adjustment to situational requirements. The associations of BRS and BEI with pain perception may reflect the antinociceptive effects arising from baroreceptor afferents, where reduced baroreflex function may contribute to the hyperalgesia characterizing fibromyalgia. The associations with affective impairments, sleep problems, and fatigue suggest that baroreflex dysfunctions are also involved in the secondary symptoms of the disorder.

An Appraisal of Electrodiagnostic Studies in Stiff Person Syndrome.

A literature review was performed on the use of electrodiagnostic (EDX) tests including nerve conduction study, electromyography, exteroceptive reflex, blink reflex, and late response in the evaluation of patients with stiff person syndrome (SPS). A web survey was conducted to report the extent of EDX testing usage in the evaluation of SPS among laboratories accredited by the American Academy of Neuromuscular and Electrodiagnostic Medicine. Coactivation of selected agonist and antagonist muscles was performed in 5 healthy subjects to determine its specificity for SPS. Observation of continuous motor unit activity on electromyography and elicitation of exteroceptive reflexes by electric stimulation are informative in assisting a diagnosis of SPS, but further studies focusing on their sensitivities in diagnosing SPS and specificities in differentiating SPS from other movement disorders are needed. The value of EDX testing in SPS lies in ruling out other neuromuscular disorders.

Retrograde cannulation of femoral artery: A novel experimental design for precise elicitation of vasosensory reflexes in anesthetized rats

Vasosensory reflex responses are elicited by instillation of nociceptive agents in a segment of peripheral blood vessel. A novel method for the stimulation of perivascular afferents was designed by retrograde cannulation of femoral artery, using a 24G, double ported polyethylene cannula. The vertical port of which was used to inject the algogen into the artery and horizontal port to measure the BP continuously, as this port was connected to the pressure transducer. Previously, separate carotid artery cannulation was used for the BP recording. But our experimental design excluded the need for carotid artery cannulation that might compromise the circulation to the CNS centers mediating cardiorespiratory reflex responses. After cannulation, the proximal end of femoral artery became an end artery and the drugs were instilled retrogradely. The volume of chemicals was kept minimal (100 µl) and the ipsilateral femoral vein was also ligated. These measures made sure that the instilled drug remained in a local segment of femoral artery and did not spill out to the systemic circulation. Further, there was no increase in the water content of ipsilateral paw as compared to the contralateral paw. This finding also substantiates our proposition regarding minimal systemic spillage.•The femoral artery is cannulated by a double ported cannula.•This cannula helps instillation of algogen and BP measurement simultaneously.•Retrograde instillation helps to deposit the algogen in a local segment of femoral artery.

Comparison of acute pressor effects of plain water, oral rehydration solution, and fruit juice ingestion in healthy young adults

Background and Objectives: Ingestion of plain water is associated with an acute rise in blood pressure, probably due to elicitation of a sympathetic reflex in patients with autonomic dysfunction. Whether the pressor response is similar in healthy individuals is disputed. Other types of fluid could have different effects. Comparison of the pressor effects of plain water ingestion with other types of fluids has been reported scantily. &#x0D; Material and methods: In a cross-over experimental study, young medical students ingested 500 mL of plain water (PW), 500 mL of oral rehydration salt solution (ORS), or 400 mL of commercial fruit juice (FJ) on separate days, with at least two days’ gap. Their heart rate (HR) and blood pressure (BP: systolic, SBP and diastolic, DBP) were recorded before, immediately after (0 min), and at 2, 5, 20, and 40 min after fluid ingestion and compared with baseline values. &#x0D; Results: Sixty nine apparently healthy medical students (40 males and 29 females, age range 18-24 years) participated in the study. Compared to baseline, SBP and DBP were significantly higher at 0, 2, and 5 min measurements with ORS and FJ; then lowered at 20 and 40 min. With the PW, BP changes were not significant at any time of measurement. In all experimental set ups, HR increased significantly at 0, 2, and 5 min and lowered to near baseline levels then after. &#x0D; Conclusion: Ingestion of ORS and FJ, but not PW, is associated with acute pressor effects in healthy young adults. This finding could have implications on the choice of fluid for prophylaxis in hypotensive conditions such as blood donation, postural hypotension, and autonomic dysfunction.

Modulation of soleus stretch reflexes during walking in people with chronic incomplete spinal cord injury

In people with spasticity due to chronic incomplete spinal cord injury (SCI), it has been presumed that the abnormal stretch reflex activity impairs gait. However, locomotor stretch reflexes across all phases of walking have not been investigated in people with SCI. Thus, to understand modulation of stretch reflex excitability during spastic gait, we investigated soleus stretch reflexes across the entire gait cycle in nine neurologically normal participants and nine participants with spasticity due to chronic incomplete SCI (2.5–11 year post-injury). While the participant walked on the treadmill at his/her preferred speed, unexpected ankle dorsiflexion perturbations (6° at 250°/s) were imposed every 4–6 steps. The soleus H-reflex was also examined. In participants without SCI, spinal short-latency “M1”, spinal medium latency “M2”, and long-latency “M3” were clearly modulated throughout the step cycle; the responses were largest in the mid-stance and almost completely suppressed during the stance-swing transition and swing phases. In participants with SCI, M1 and M2 were abnormally large in the mid–late-swing phase, while M3 modulation was similar to that in participants without SCI. The H-reflex was also large in the mid–late-swing phase. Elicitation of H-reflex and stretch reflexes in the late swing often triggered clonus and affected the soleus activity in the following stance. In individuals without SCI, moderate positive correlation was found between H-reflex and stretch reflex sizes across the step cycle, whereas in participants with SCI, such correlation was weak to non-existing, suggesting that H-reflex investigation would not substitute for stretch reflex investigation in individuals after SCI.

Excitatory and inhibitory crossed reflex pathways in mice.

Sensory information from one leg has been known to elicit reflex responses in the contralateral leg, known as "crossed reflexes," and these have been investigated extensively in cats and humans. Furthermore, experiments with mice have shown commissural pathways in detail by using in vitro and in vivo physiological approaches combined with genetics. However, the relationship between these commissural pathways discovered in mice and crossed reflex pathways described in cats and humans is not known. In this study, we analyzed the crossed reflex in mice by using in vivo electromyographic recording techniques combined with peripheral nerve stimulation protocols to provide a detailed description of the crossed reflex pathways. We show that excitatory crossed reflexes are mediated by both proprioceptive and cutaneous afferent activation. In addition, we provide evidence for a short-latency inhibitory crossed reflex pathway likely mediated by cutaneous feedback. Furthermore, the short-latency crossed inhibition is downregulated in the knee extensor muscle and the ankle flexor muscle during locomotion. In conclusion, this article provides an analysis of excitatory and inhibitory crossed reflex pathways during resting and locomoting mice in vivo. The data presented in this article pave the way for future research aimed at understanding crossed reflexes using genetics in mice. NEW & NOTEWORTHY We describe for the first time excitatory and inhibitory crossed reflex pathways in mouse spinal cord in vivo and show that the inhibitory pathways are modulated during walking. This is a first step toward an understanding of crossed reflexes and their function during walking using in vivo recording techniques combined with mouse genetics.

Human laryngeal sensory receptor mapping illuminates the mechanisms of laryngeal adductor reflex control

The laryngeal adductor reflex (LAR) is an airway protective response triggered by sensory laryngeal receptors. It is unknown whether different glottic and supraglottic subsites vary in their reflex elicitation abilities. The recent discovery that a bilateral LAR is present in humans under general anesthesia upon laryngeal mucosal stimulation has enabled us to map the sensory receptor density for LAR elicitation at different laryngeal subsites. Our findings expose the likely mechanisms of LAR control. Prospective series of 10 patients undergoing laryngoscopy. Laryngeal subsites (epiglottic tip, membranous vocal fold, midventricular vocal fold, posterior supraglottis, epiglottic petiole) were stimulated via direct laryngoscopy with a bipolar probe. Vocal fold responses were recorded by endotracheal tube and hook wire electrodes, and visual observation. Posterior supraglottic stimulation elicited bilateral LARs in all patients at all intensities. Membranous vocal folds, epiglottic petiole, and subglottis elicited no LAR. Ventricular fold and epiglottic tip responses converted from ipsi- to bilateral at high intensities. There are likely three checkpoints for control of the LAR in humans. These checkpoints protect against inappropriate LAR activation during volitional tasks without compromising airway protection: 1) topographical differences in receptor density with the highest density in subsites most likely to contact foreign substances; 2) absence of receptors in membranous vocal folds; and 3) central summation threshold for crossed interneuron activation at brainstem level where only strong intensity stimuli will elicit bilateral responses. Checkpoint dysfunction provides a novel framework to diagnose and treat disease processes, including aspiration, laryngospasm, and sudden infant death. 4. Laryngoscope, E365-E370, 2018.

Common neural structures activated by epidural and transcutaneous lumbar spinal cord stimulation: Elicitation of posterior root-muscle reflexes.

Epidural electrical stimulation of the lumbar spinal cord is currently regaining momentum as a neuromodulation intervention in spinal cord injury (SCI) to modify dysregulated sensorimotor functions and augment residual motor capacity. There is ample evidence that it engages spinal circuits through the electrical stimulation of large-to-medium diameter afferent fibers within lumbar and upper sacral posterior roots. Recent pilot studies suggested that the surface electrode-based method of transcutaneous spinal cord stimulation (SCS) may produce similar neuromodulatory effects as caused by epidural SCS. Neurophysiological and computer modeling studies proposed that this noninvasive technique stimulates posterior-root fibers as well, likely activating similar input structures to the spinal cord as epidural stimulation. Here, we add a yet missing piece of evidence substantiating this assumption. We conducted in-depth analyses and direct comparisons of the electromyographic (EMG) characteristics of short-latency responses in multiple leg muscles to both stimulation techniques derived from ten individuals with SCI each. Post-activation depression of responses evoked by paired pulses applied either epidurally or transcutaneously confirmed the reflex nature of the responses. The muscle responses to both techniques had the same latencies, EMG peak-to-peak amplitudes, and waveforms, except for smaller responses with shorter onset latencies in the triceps surae muscle group and shorter offsets of the responses in the biceps femoris muscle during epidural stimulation. Responses obtained in three subjects tested with both methods at different time points had near-identical waveforms per muscle group as well as same onset latencies. The present results strongly corroborate the activation of common neural input structures to the lumbar spinal cord—predominantly primary afferent fibers within multiple posterior roots—by both techniques and add to unraveling the basic mechanisms underlying electrical SCS.

"Relationship between Modified Ashworth Scale and Alpha Motoneuron Excitabilityin Spinal Cord Lesions"

Background:&nbsp;Spasticity is one of the major neurological complications occurring in people with Spinal Cord Lesions due to loss of supra-spinal and spinal control over alpha motor neuron activity. Its accurate assessment is necessary for tailoring patient specific rehabilitation program. Clinical assessment is commonly done through Modified Ashworth Scale where in the examiner subjectively judges resistance to passive range of motion whereas, electrophysiological quantification of spasticity can be done through Hoffman’s Reflex which is an estimate of alpha motor neuron activity.Methods:&nbsp;This co-relational study establishes an association between MAS and H reflex in a sample of both traumatic and non-traumatic Spinal Cord lesion patients. A sample of 22 patients was obtained who were rated for MAS grades 0,1,1+,2 and 3 in bilateral gastro soleus and consequent H reflex elicitation was done.Results:&nbsp;Karl Pearson Correlation coefficient was calculated between MAS and H amplitude (r = 0.342, p&lt;0.05); MAS and h latency (r = 0.013, p&gt;0.05) ; MAS and H/M ratio (r=0.190 ,p&gt;0.05).Conclusion:&nbsp;It was concluded that there exists a weak but significant correlation between MAS and H amplitude but non-significant relationship between MAS and H latency; MAS and H/M ratio.

Multi-Electrode Array for Transcutaneous Lumbar Posterior Root Stimulation.

Interest in transcutaneous electrical stimulation of the lumbosacral spinal cord is increasing in human electrophysiological and clinical studies. The stimulation effects on lower limb muscles depend on the depolarization of segmentally organized posterior root afferents and, thus, the rostro-caudal stimulation site. In previous studies, selective stimulation was achieved by varying the positions of single self-adhesive electrodes over the thoracolumbar spine. Here, we developed a multi-electrode surface array consisting of 3 × 8 electrode pads and tested its stimulation-site specificity. The array was placed longitudinally over the spine covering the T10-L2 vertebrae. Two different hydrogel layer configurations were utilized: a single layer adhered to all electrode pads of the array and a configuration comprised of eight separate strips attached to the three transverse electrode pads of each level. Voltage measurements demonstrated that an effectively focused field distribution along the longitudinal extent of the array was not accomplished when using the single continuous hydrogel layer, and segmental selective stimulation of the posterior root afferents was not possible. The separate strips produced a focused electric field distribution at the rostro-caudal level of the electrode pads selected for stimulation. This configuration allowed for the preferential elicitation of posterior root-muscle reflexes in either the L2-L4 innervated quadriceps or the L5-S2 innervated triceps surae muscle groups. Such multi-electrode array for transcutaneous spinal cord stimulation shall allow for improved control of stimulation conditions in electrophysiological studies and time-dependent and site-specific stimulation patterns for neuromodulation applications.

Sensation within the skin.

This Viewpoint emphasizes interoceptive discriminative stimulus modulation of voluntary operant behavior (a la B. F. Skinner), rather than elicitation of Pavlovian conditioned reflexes. In doing so, I will restate how the operant drug discrimination paradigm may not only elucidate smoking and other addictive behaviors but also anxiety (Troisi, J. R., II. (2003) Spontaneous recovery during, but not following, extinction of the discriminative stimulus effects of nicotine in rats: Reinstatement of stimulus control. Psychol. Rec. 53, 579-592).

Hip proprioceptors preferentially modulate reflexes of the leg in human spinal cord injury

Stretch-sensitive afferent feedback from hip muscles has been shown to trigger long-lasting, multijoint reflex responses in people with chronic spinal cord injury (SCI). These reflexes could have important implications for control of leg movements during functional activities, such as walking. Because the control of leg movement relies on reflex regulation at all joints of the limb, we sought to determine whether stretch of hip muscles modulates reflex activity at the knee and ankle and, conversely, whether knee and ankle stretch afferents affect hip-triggered reflexes. A custom-built servomotor apparatus was used to stretch the hip muscles in nine chronic SCI subjects by oscillating the legs about the hip joint bilaterally from 10° of extension to 40° flexion. To test whether stretch-related feedback from the knee or ankle would be affected by hip movement, patellar tendon percussions and Achilles tendon vibration were delivered when the hip was either extending or flexing. Surface electromyograms (EMGs) and joint torques were recorded from both legs. Patellar tendon percussions and Achilles tendon vibration both elicited reflex responses local to the knee or ankle, respectively, and did not influence reflex responses observed at the hip. Rather, the movement direction of the hip modulated the reflex responses local to the joint. The patellar tendon reflex amplitude was larger when the perturbation was delivered during hip extension compared with hip flexion. The response to Achilles vibration was modulated by hip movement, with an increased tonic component during hip flexion compared with extension. These results demonstrate that hip-mediated sensory signals modulate activity in distal muscles of the leg and appear to play a unique role in modulation of spastic muscle activity throughout the leg in SCI.

Operant conditioning of spinal reflexes to improve function recovery after CNS damage

The elicitation of spinal reflexes, which has traditionally been used to monitor basic motor and sensory functions, is now finding uses for modifying CNS pathways and thereby restoring more effective function after spinal cord injuries and in other disorders. Reflex conditioning protocols can changes the simple pathways that are responsible for these reflexes. These changes reflect multi‐site anatomical and physiological plasticity. Because these simple pathways are also important for complex motor skills such as locomotion, modifications in them also affect important skills. Reflex conditioning protocols can be designed to target each person's particular deficits and can thereby supplement traditional rehabilitation methods.

Perivagal antagonist treatment in rats selectively blocks the reflex and afferent responses of vagal lung C fibers to intravenous agonists

The terminals of vagal lung C fibers (VLCFs) express various types of pharmacological receptors that are important to the elicitation of airway reflexes and the development of airway hypersensitivity. We investigated the blockade of the reflex and afferent responses of VLCFs to intravenous injections of agonists using perivagal treatment with antagonists (PAT) targeting the transient receptor potential vanilloid 1, P2X, and 5-HT(3) receptors in anesthetized rats. Blockading these responses via perivagal capsaicin treatment (PCT), which blocks the neural conduction of C fibers, was also studied. We used capsaicin, α,β-methylene-ATP, and phenylbiguanide as the agonists, and capsazepine, iso-pyridoxalphosphate-6-azophenyl-2',5'-disulfonate, and tropisetron as the antagonists of transient receptor potential vanilloid 1, P2X, and 5-HT(3) receptors, respectively. We found that each of the PATs abolished the VLCF-mediated reflex apnea evoked by the corresponding agonist, while having no effect on the response to other agonists. Perivagal vehicle treatment failed to produce any such blockade. These blockades had partially recovered at 3 h after removal of the PATs. In contrast, PCT abolished the reflex apneic response to all three agonists. Both PATs and PCT did not affect the myelinated afferent-mediated apneic response to lung inflation. Consistently, our electrophysiological studies revealed that each of the PATs prevented the VLCF responses to the corresponding agonist, but not to any other agonist. PCT inevitably prevented the VLCF responses to all three agonists. Thus these PATs selectively blocked the stimulatory action of corresponding agonists on the VLCF terminals via mechanisms that are distinct from those of PCT. PAT may become a novel intervention for studying the pharmacological modulation of VLCFs.