Respiratory control is a very complex process. The simple answer to this
question is that the brain stem control respiration. Scientists are trying
to isolate the specific mechanism in an attempt to offer treatment/cure to
the children born with CCHS. The research has clearly demonstrated that
respiratory control involves a mix of both central and peripheral
chemoreceptor systems. Children with CCHS are shoting a hole through this
theory as recent studies show that they actually have functioning central
and peripheral receptor systems. Exactly where those signals/responses
occur within the brain is the subject of much debate. The latest data that
I've seen, using functional brain MRI, suggests that the PONS is ultimately
responsible for this process. Older published literature suggests that the
ventilatory response to CO2 is processed within the medullary chemoreceptor
system. The functional MRI studies are very impressive and may be the most
accurate.
Studies attempting to isolate the exact location of the ventilatory drive
mechanism are underway at several centers across the US. Unfortunately
none of those research studies are funded and the surviving patient
population base on from which the scientists can draw is very, very small.
As a result the process is extremely slow and information or database
release even slower.
Studies are also underway looking at the genetic link to idiopathic
disorders of respiratory control. So maybe someday gene therapy will be
available for the CCHS and SIDS population. There is hope for the distant
future.
Joanne Kocourek
The University of Chicago
jskocour(AT)midway.uchicago.edu