Assessment of ‘neural respiratory drive’ from the parasternal intercostal muscles

The complexities associated with measuring respiratory muscle electromyography (EMG) in human participants are well known (see Hudson and Laveneziana, 2015). As an estimate of neural respiratory drive (NRD) during cardiopulmonary exercise testing, the current ‘gold standard’ methodology is a multi-pair oesophageal catheter to measure diaphragm activity during inspiration, which is quantified as a proportion of maximal activity recorded during voluntary ‘maximal’ efforts, i.e. EMGdi%max. However, due to the relatively invasive nature of this technique, there has been a recent focus to find an alternative method to estimate NRD in rest and exercise for clinical applications...