The brainstem respiratory network: an overview of a half century of research

This review aims at summarizing the work performed over 40 years by Professor Armand Bianchi and the research team he directed, which was devoted to the study of the central respiratory network. The major steps towards the understanding of this complex network will be presented together with methodological considerations. This includes the sequential progress that was made in the identification and characterization of respiratory neurons as deduced from inferences gleaned from intracellular recordings, which revealed putative synaptic connections within the respiratory network. Also reviewed is a comparison of in vivo versus in vitro approaches. The search for the "real" respiratory neurons must consider that those neurons are redundantly represented within the brainstem and express a wide variety of patterns. The last part of this review focuses on the concept that the brainstem respiratory circuitry forms part of a multifunctional network subserving both respiration and non-respiratory motor behaviors. Numerous data provide evidence that the respiratory network operates as a dynamic assembly of neurons, some of which can belong to several networks involved in the coordination of respiratory muscles during functions that include coughing, swallowing and vomiting.