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Yorita A, Kawayama T, Inoue M, Kinoshita T, Oda H, Tokunaga Y, Tateishi T, Shoji Y, Uchimura N, Abe T, Hoshino T, Taniwaki T. Altered Functional Connectivity during Mild Transient Respiratory Impairment Induced by a Resistive Load. J Clin Med 2024; 13:2556. [PMID: 38731091 PMCID: PMC11084533 DOI: 10.3390/jcm13092556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Previous neuroimaging studies have identified brain regions related to respiratory motor control and perception. However, little is known about the resting-state functional connectivity (FC) associated with respiratory impairment. We aimed to determine the FC involved in mild respiratory impairment without altering transcutaneous oxygen saturation. Methods: We obtained resting-state functional magnetic resonance imaging data from 36 healthy volunteers during normal respiration and mild respiratory impairment induced by resistive load (effort breathing). ROI-to-ROI and seed-to-voxel analyses were performed using Statistical Parametric Mapping 12 and the CONN toolbox. Results: Compared to normal respiration, effort breathing activated FCs within and between the sensory perceptual area (postcentral gyrus, anterior insular cortex (AInsula), and anterior cingulate cortex) and visual cortex (the visual occipital, occipital pole (OP), and occipital fusiform gyrus). Graph theoretical analysis showed strong centrality in the visual cortex. A significant positive correlation was observed between the dyspnoea score (modified Borg scale) and FC between the left AInsula and right OP. Conclusions: These results suggested that the FCs within the respiratory sensory area via the network hub may be neural mechanisms underlying effort breathing and modified Borg scale scores. These findings may provide new insights into the visual networks that contribute to mild respiratory impairments.
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Affiliation(s)
- Akiko Yorita
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Masayuki Inoue
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume 830-0011, Japan; (M.I.); (Y.S.); (N.U.)
| | - Takashi Kinoshita
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Hanako Oda
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Yoshihisa Tokunaga
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Takahisa Tateishi
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Yoshihisa Shoji
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume 830-0011, Japan; (M.I.); (Y.S.); (N.U.)
| | - Naohisa Uchimura
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume 830-0011, Japan; (M.I.); (Y.S.); (N.U.)
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume 830-0011, Japan;
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Takayuki Taniwaki
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
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Reddy NA, Clements RG, Brooks JCW, Bright MG. Simultaneous cortical, subcortical, and brainstem mapping of sensory activation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.11.589099. [PMID: 38659741 PMCID: PMC11042175 DOI: 10.1101/2024.04.11.589099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Non-painful tactile sensory stimuli are processed in the cortex, subcortex, and brainstem. Recent functional magnetic resonance imaging (fMRI) studies have highlighted the value of whole-brain, systems-level investigation for examining pain processing. However, whole-brain fMRI studies are uncommon, in part due to challenges with signal to noise when studying the brainstem. Furthermore, the differentiation of small sensory brainstem structures such as the cuneate and gracile nuclei necessitates high resolution imaging. To address this gap in systems-level sensory investigation, we employed a whole-brain, multi-echo fMRI acquisition at 3T with multi-echo independent component analysis (ME-ICA) denoising and brainstem-specific modeling to enable detection of activation across the entire sensory system. In healthy participants, we examined patterns of activity in response to non-painful brushing of the right hand, left hand, and right foot, and found the expected lateralization, with distinct cortical and subcortical responses for upper and lower limb stimulation. At the brainstem level, we were able to differentiate the small, adjacent cuneate and gracile nuclei, corresponding to hand and foot stimulation respectively. Our findings demonstrate that simultaneous cortical, subcortical, and brainstem mapping at 3T could be a key tool to understand the sensory system in both healthy individuals and clinical cohorts with sensory deficits.
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Affiliation(s)
- Neha A. Reddy
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering and Applied Sciences, Northwestern University, Evanston, IL, United States
| | - Rebecca G. Clements
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering and Applied Sciences, Northwestern University, Evanston, IL, United States
| | | | - Molly G. Bright
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering and Applied Sciences, Northwestern University, Evanston, IL, United States
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3
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De Falco E, Solcà M, Bernasconi F, Babo-Rebelo M, Young N, Sammartino F, Tallon-Baudry C, Navarro V, Rezai AR, Krishna V, Blanke O. Single neurons in the thalamus and subthalamic nucleus process cardiac and respiratory signals in humans. Proc Natl Acad Sci U S A 2024; 121:e2316365121. [PMID: 38451949 PMCID: PMC10945861 DOI: 10.1073/pnas.2316365121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/16/2024] [Indexed: 03/09/2024] Open
Abstract
Visceral signals are constantly processed by our central nervous system, enable homeostatic regulation, and influence perception, emotion, and cognition. While visceral processes at the cortical level have been extensively studied using non-invasive imaging techniques, very few studies have investigated how this information is processed at the single neuron level, both in humans and animals. Subcortical regions, relaying signals from peripheral interoceptors to cortical structures, are particularly understudied and how visceral information is processed in thalamic and subthalamic structures remains largely unknown. Here, we took advantage of intraoperative microelectrode recordings in patients undergoing surgery for deep brain stimulation (DBS) to investigate the activity of single neurons related to cardiac and respiratory functions in three subcortical regions: ventral intermedius nucleus (Vim) and ventral caudalis nucleus (Vc) of the thalamus, and subthalamic nucleus (STN). We report that the activity of a large portion of the recorded neurons (about 70%) was modulated by either the heartbeat, the cardiac inter-beat interval, or the respiration. These cardiac and respiratory response patterns varied largely across neurons both in terms of timing and their kind of modulation. A substantial proportion of these visceral neurons (30%) was responsive to more than one of the tested signals, underlining specialization and integration of cardiac and respiratory signals in STN and thalamic neurons. By extensively describing single unit activity related to cardiorespiratory function in thalamic and subthalamic neurons, our results highlight the major role of these subcortical regions in the processing of visceral signals.
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Affiliation(s)
- Emanuela De Falco
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Neuroscience, Rockefeller Neuroscience Institute–West Virginia University, Morgantown, WV26505
| | - Marco Solcà
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Psychiatry, University Hospital Geneva, Geneva1205, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
| | - Mariana Babo-Rebelo
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
| | - Nicole Young
- Medical Department, SpecialtyCare, Brentwood, TN37027
| | - Francesco Sammartino
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, OH43210
| | - Catherine Tallon-Baudry
- Laboratoire de Neurosciences Cognitives et Computationnelles, Département d’Etudes Cognitives, École normale supérieure-Paris Sciences et Lettres University, Inserm, Paris75005, France
| | - Vincent Navarro
- Sorbonne Université, Paris Brain Institute—Institut du Cerveau et de la Moelle épinière, Inserm, CNRS, Assistance Publique - Hôpitaux de Paris, Epilepsy Unit, Hôpital de la Pitié-Salpêtrière, Paris75013, France
| | - Ali R. Rezai
- Department of Neurosurgery, Rockefeller Neuroscience Institute—West Virginia University, Morgantown, WV26505
| | - Vibhor Krishna
- Department of Neurosurgery, University of North Carolina at Chapel Hill, Durham, NC27516
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, School of Life Sciences, Neuro-X Institute and Brain Mind Institute, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
- Department of Clinical Neurosciences, University Hospital Geneva, Geneva1205, Switzerland
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4
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Woodward OB, Driver I, Schwarz ST, Hart E, Wise R. Assessment of brainstem function and haemodynamics by MRI: challenges and clinical prospects. Br J Radiol 2023; 96:20220940. [PMID: 37721043 PMCID: PMC10607409 DOI: 10.1259/bjr.20220940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 04/25/2023] [Accepted: 05/24/2023] [Indexed: 09/19/2023] Open
Abstract
MRI offers techniques for non-invasively measuring a range of aspects of brain tissue function. Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) is widely used to assess neural activity, based on the brain's haemodynamic response, while arterial spin labelling (ASL) MRI is a non-invasive method of quantitatively mapping cerebral perfusion. Both techniques can be applied to measure cerebrovascular reactivity (CVR), an important marker of the health of the cerebrovascular system. BOLD, ASL and CVR have been applied to study a variety of disease processes and are already used in certain clinical circumstances. The brainstem is a critical component of the central nervous system and is implicated in a variety of disease processes. However, its function is difficult to study using MRI because of its small size and susceptibility to physiological noise. In this article, we review the physical and biological underpinnings of BOLD and ASL and their application to measure CVR, discuss the challenges associated with applying them to the brainstem and the opportunities for brainstem MRI in the research and clinical settings. With further optimisation, functional MRI techniques could feasibly be used to assess brainstem haemodynamics and neural activity in the clinical setting.
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Affiliation(s)
- Owen Bleddyn Woodward
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom
| | - Ian Driver
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom
| | | | - Emma Hart
- University of Bristol, Bristol, United Kingdom
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5
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Xie Y, Zhang L, Guo S, Peng R, Gong H, Yang M. Changes in respiratory structure and function after traumatic cervical spinal cord injury: observations from spinal cord and brain. Front Neurol 2023; 14:1251833. [PMID: 37869136 PMCID: PMC10587692 DOI: 10.3389/fneur.2023.1251833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Respiratory difficulties and mortality following severe cervical spinal cord injury (CSCI) result primarily from malfunctions of respiratory pathways and the paralyzed diaphragm. Nonetheless, individuals with CSCI can experience partial recovery of respiratory function through respiratory neuroplasticity. For decades, researchers have revealed the potential mechanism of respiratory nerve plasticity after CSCI, and have made progress in tissue healing and functional recovery. While most existing studies on respiratory plasticity after spinal cord injuries have focused on the cervical spinal cord, there is a paucity of research on respiratory-related brain structures following such injuries. Given the interconnectedness of the spinal cord and the brain, traumatic changes to the former can also impact the latter. Consequently, are there other potential therapeutic targets to consider? This review introduces the anatomy and physiology of typical respiratory centers, explores alterations in respiratory function following spinal cord injuries, and delves into the structural foundations of modified respiratory function in patients with CSCI. Additionally, we propose that magnetic resonance neuroimaging holds promise in the study of respiratory function post-CSCI. By studying respiratory plasticity in the brain and spinal cord after CSCI, we hope to guide future clinical work.
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Affiliation(s)
- Yongqi Xie
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Liang Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Shuang Guo
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Rehabilitation, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Run Peng
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Huiming Gong
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Mingliang Yang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China
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6
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Goheen J, Anderson JAE, Zhang J, Northoff G. From Lung to Brain: Respiration Modulates Neural and Mental Activity. Neurosci Bull 2023; 39:1577-1590. [PMID: 37285017 PMCID: PMC10533478 DOI: 10.1007/s12264-023-01070-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/10/2023] [Indexed: 06/08/2023] Open
Abstract
Respiration protocols have been developed to manipulate mental states, including their use for therapeutic purposes. In this systematic review, we discuss evidence that respiration may play a fundamental role in coordinating neural activity, behavior, and emotion. The main findings are: (1) respiration affects the neural activity of a wide variety of regions in the brain; (2) respiration modulates different frequency ranges in the brain's dynamics; (3) different respiration protocols (spontaneous, hyperventilation, slow or resonance respiration) yield different neural and mental effects; and (4) the effects of respiration on the brain are related to concurrent modulation of biochemical (oxygen delivery, pH) and physiological (cerebral blood flow, heart rate variability) variables. We conclude that respiration may be an integral rhythm of the brain's neural activity. This provides an intimate connection of respiration with neuro-mental features like emotion. A respiratory-neuro-mental connection holds the promise for a brain-based therapeutic usage of respiration in mental disorders.
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Affiliation(s)
- Josh Goheen
- The Royal Ottawa Mental Health Centre, The University of Ottawa, Ottawa, K1Z 7K4, Canada.
- Department of Cognitive Science, Carleton University, Ottawa, K1S 5B6, Canada.
| | - John A E Anderson
- Department of Cognitive Science, Carleton University, Ottawa, K1S 5B6, Canada
| | - Jianfeng Zhang
- Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, 518060, China
- School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Georg Northoff
- The Royal Ottawa Mental Health Centre, The University of Ottawa, Ottawa, K1Z 7K4, Canada
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7
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Zhang X, Liu W, Xu F, He W, Song Y, Li G, Zhang Y, Dai G, Xiao Q, Meng Q, Zeng X, Bai S, Zhong R. Neural signals-based respiratory motion tracking: a proof-of-concept study. Phys Med Biol 2023; 68:195015. [PMID: 37683675 DOI: 10.1088/1361-6560/acf819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/08/2023] [Indexed: 09/10/2023]
Abstract
Objective.Respiratory motion tracking techniques can provide optimal treatment accuracy for thoracoabdominal radiotherapy and robotic surgery. However, conventional imaging-based respiratory motion tracking techniques are time-lagged owing to the system latency of medical linear accelerators and surgical robots. This study aims to investigate the precursor time of respiratory-related neural signals and analyze the potential of neural signals-based respiratory motion tracking.Approach.The neural signals and respiratory motion from eighteen healthy volunteers were acquired simultaneously using a 256-channel scalp electroencephalography (EEG) system. The neural signals were preprocessed using the MNE python package to extract respiratory-related EEG neural signals. Cross-correlation analysis was performed to assess the precursor time and cross-correlation coefficient between respiratory-related EEG neural signals and respiratory motion.Main results.Respiratory-related neural signals that precede the emergence of respiratory motion are detectable via non-invasive EEG. On average, the precursor time of respiratory-related EEG neural signals was 0.68 s. The representative cross-correlation coefficients between EEG neural signals and respiratory motion of the eighteen healthy subjects varied from 0.22 to 0.87.Significance.Our findings suggest that neural signals have the potential to compensate for the system latency of medical linear accelerators and surgical robots. This indicates that neural signals-based respiratory motion tracking is a potential promising solution to respiratory motion and could be useful in thoracoabdominal radiotherapy and robotic surgery.
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Affiliation(s)
- Xiangbin Zhang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Wenjie Liu
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, People's Republic of China
| | - Feng Xu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Weizhong He
- Magstim Electrical Geodesics, Inc, Plymouth, MA, United States of America
| | - Yingpeng Song
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Guangjun Li
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yingjie Zhang
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Guyu Dai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qing Xiao
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qianqian Meng
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xianhu Zeng
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Sen Bai
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Renming Zhong
- Radiotherapy Physics and Technology Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Moll FW, Kranz D, Corredera Asensio A, Elmaleh M, Ackert-Smith LA, Long MA. Thalamus drives vocal onsets in the zebra finch courtship song. Nature 2023; 616:132-136. [PMID: 36949189 DOI: 10.1038/s41586-023-05818-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 02/09/2023] [Indexed: 03/24/2023]
Abstract
While motor cortical circuits contain information related to specific movement parameters1, long-range inputs also have a critical role in action execution2,3. Thalamic projections can shape premotor activity2-6 and have been suggested7 to mediate the selection of short, stereotyped actions comprising more complex behaviours8. However, the mechanisms by which thalamus interacts with motor cortical circuits to execute such movement sequences remain unknown. Here we find that thalamic drive engages a specific subpopulation of premotor neurons within the zebra finch song nucleus HVC (proper name) and that these inputs are critical for the progression between vocal motor elements (that is, 'syllables'). In vivo two-photon imaging of thalamic axons in HVC showed robust song-related activity, and online perturbations of thalamic function caused song to be truncated at syllable boundaries. We used thalamic stimulation to identify a sparse set of thalamically driven neurons within HVC, representing ~15% of the premotor neurons within that network. Unexpectedly, this population of putative thalamorecipient neurons is robustly active immediately preceding syllable onset, leading to the possibility that thalamic input can initiate individual song components through selectively targeting these 'starter cells'. Our findings highlight the motor thalamus as a director of cortical dynamics in the context of an ethologically relevant behavioural sequence.
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Affiliation(s)
- Felix W Moll
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY, USA
- Center for Neural Science, New York University, New York, NY, USA
- Animal Physiology, Institute of Neurobiology, University of Tübingen, Tübingen, Germany
| | - Devorah Kranz
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY, USA
- Center for Neural Science, New York University, New York, NY, USA
| | - Ariadna Corredera Asensio
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY, USA
- Center for Neural Science, New York University, New York, NY, USA
| | - Margot Elmaleh
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY, USA
- Center for Neural Science, New York University, New York, NY, USA
| | - Lyn A Ackert-Smith
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY, USA
- Center for Neural Science, New York University, New York, NY, USA
| | - Michael A Long
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY, USA.
- Center for Neural Science, New York University, New York, NY, USA.
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9
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Ciumas C, Rheims S, Ryvlin P. fMRI studies evaluating central respiratory control in humans. Front Neural Circuits 2022; 16:982963. [PMID: 36213203 PMCID: PMC9537466 DOI: 10.3389/fncir.2022.982963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
A plethora of neural centers in the central nervous system control the fundamental respiratory pattern. This control is ensured by neurons that act as pacemakers, modulating activity through chemical control driven by changes in the O2/CO2 balance. Most of the respiratory neural centers are located in the brainstem, but difficult to localize on magnetic resonance imaging (MRI) due to their small size, lack of visually-detectable borders with neighboring areas, and significant physiological noise hampering detection of its activity with functional MRI (fMRI). Yet, several approaches make it possible to study the normal response to different abnormal stimuli or conditions such as CO2 inhalation, induced hypercapnia, volitional apnea, induced hypoxia etc. This review provides a comprehensive overview of the majority of available studies on central respiratory control in humans.
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Affiliation(s)
- Carolina Ciumas
- Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Lyon Neuroscience Research Center, Institut National de la Santé et de la Recherche Médicale U1028/CNRS UMR 5292 Lyon 1 University, Bron, France
- IDEE Epilepsy Institute, Lyon, France
- *Correspondence: Carolina Ciumas
| | - Sylvain Rheims
- Lyon Neuroscience Research Center, Institut National de la Santé et de la Recherche Médicale U1028/CNRS UMR 5292 Lyon 1 University, Bron, France
- IDEE Epilepsy Institute, Lyon, France
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Lyon, France
| | - Philippe Ryvlin
- Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Hampson JP, Lacuey N, Rani MRS, Hampson JS, Simeone KA, Simeone TA, Narayana PA, Lemieux L, Lhatoo SD. Functional MRI Correlates of Carbon Dioxide Chemosensing in Persons With Epilepsy. Front Neurol 2022; 13:896204. [PMID: 35873766 PMCID: PMC9301231 DOI: 10.3389/fneur.2022.896204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives Sudden unexpected death in epilepsy (SUDEP) is a catastrophic epilepsy outcome for which there are no reliable premortem imaging biomarkers of risk. Percival respiratory depression is seen in monitored SUDEP and near SUDEP cases, and abnormal chemosensing of raised blood carbon dioxide (CO2) is thought to contribute. Damage to brainstem respiratory control and chemosensing structures has been demonstrated in structural imaging and neuropathological studies of SUDEP. We hypothesized that functional MRI (fMRI) correlates of abnormal chemosensing are detectable in brainstems of persons with epilepsy (PWE) and are different from healthy controls (HC). Methods We analyzed fMRI BOLD activation and brain connectivity in 10 PWE and 10 age- and sex-matched HCs during precisely metered iso-oxic, hypercapnic breathing challenges. Segmented brainstem responses were of particular interest, along with characterization of functional connectivity metrics between these structures. Regional BOLD activations during hypercapnic challenges were convolved with hemodynamic responses, and the resulting activation maps were passed on to group-level analyses. For the functional connectivity analysis, significant clusters from BOLD results were used as seeds. Each individual seed time-series activation map was extracted for bivariate correlation coefficient analyses to study changes in brain connectivity between PWE and HCs. Results (1) Greater brainstem BOLD activations in PWE were observed compared to HC during hypercapnic challenges in several structures with respiratory/chemosensing properties. Group comparison between PWE vs. HC showed significantly greater activation in the dorsal raphe among PWE (p < 0.05) compared to HCs. (2) PWE had significantly greater seed-seed connectivity and recruited more structures during hypercapnia compared to HC. Significance The results of this study show that BOLD responses to hypercapnia in human brainstem are detectable and different in PWE compared to HC. Increased dorsal raphe BOLD activation in PWE and increased seed-seed connectivity between brainstem and adjacent subcortical areas may indicate abnormal chemosensing in these individuals. Imaging investigation of brainstem respiratory centers involved in respiratory regulation in PWE is an important step toward identifying suspected dysfunction of brainstem breathing control that culminates in SUDEP and deserve further study as potential imaging SUDEP biomarkers.
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Affiliation(s)
- Johnson P. Hampson
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Nuria Lacuey
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - MR Sandhya Rani
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jaison S. Hampson
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Kristina A. Simeone
- Department of Pharmacology and Neuroscience, Creighton University School of Medicine, Omaha, NE, United States
| | - Timothy A. Simeone
- Department of Pharmacology and Neuroscience, Creighton University School of Medicine, Omaha, NE, United States
| | - Ponnada A. Narayana
- Department of Diagnostic and Interventional Imaging, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Louis Lemieux
- Department of Clinical and Experimental Epilepsy, University College London (UCL) Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Samden D. Lhatoo
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
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11
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Betka S, Adler D, Similowski T, Blanke O. Breathing control, brain, and bodily self-consciousness: Toward immersive digiceuticals to alleviate respiratory suffering. Biol Psychol 2022; 171:108329. [PMID: 35452780 DOI: 10.1016/j.biopsycho.2022.108329] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 01/19/2023]
Abstract
Breathing is peculiar among autonomic functions through several characteristics. It generates a very rich afferent traffic from an array of structures belonging to the respiratory system to various areas of the brain. It is intimately associated with bodily movements. It bears particular relationships with consciousness as its efferent motor control can be automatic or voluntary. In this review within the scope of "respiratory neurophysiology" or "respiratory neuroscience", we describe the physiological organisation of breathing control. We then review findings linking breathing and bodily self-consciousness through respiratory manipulations using virtual reality (VR). After discussing the currently admitted neurophysiological model for dyspnea, as well as a new Bayesian model applied to breathing control, we propose that visuo-respiratory paradigms -as developed in cognitive neuroscience- will foster insights into some of the basic mechanisms of the human respiratory system and will also lead to the development of immersive VR-based digital health tools (i.e. digiceuticals).
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Affiliation(s)
- Sophie Betka
- Laboratory of Cognitive Neuroscience, Brain Mind Institute and Center for Neuroprosthetics, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, (EPFL), Geneva 1202, Switzerland.
| | - Dan Adler
- Division of Lung Diseases, University Hospital and Geneva Medical School, University of Geneva, Switzerland
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département R3S (Respiration, Réanimation, Réhabilitation respiratoire, Sommeil), F-75013 Paris, France
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Brain Mind Institute and Center for Neuroprosthetics, Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, (EPFL), Geneva 1202, Switzerland; Department of Clinical Neurosciences, University Hospital and Geneva Medical School, University of Geneva, Switzerland
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12
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Santarnecchi E, Sprugnoli G, Sicilia I, Dukart J, Neri F, Romanella SM, Cerase A, Vatti G, Rocchi R, Rossi A. Thalamic altered spontaneous activity and connectivity in obstructive sleep apnea syndrome. J Neuroimaging 2022; 32:314-327. [PMID: 34964182 PMCID: PMC9094633 DOI: 10.1111/jon.12952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/30/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Obstructive sleep apnea (OSA) syndrome is a sleep disorder characterized by excessive snoring, repetitive apneas, and nocturnal arousals, that leads to fragmented sleep and intermittent nocturnal hypoxemia. Morphometric and functional brain alterations in cortical and subcortical structures have been documented in these patients via magnetic resonance imaging (MRI), even if correlational data between the alterations in the brain and cognitive and clinical indexes are still not reported. METHODS We examined the impact of OSA on brain spontaneous activity by measuring the fractional amplitude of low-frequency fluctuations (fALFF) in resting-state functional MRI data of 20 drug-naïve patients with OSA syndrome and 20 healthy controls matched for age, gender, and body mass index. RESULTS Patients showed a pattern of significantly abnormal subcortical functional activity as compared to controls, with increased activity selectively involving the thalami, specifically their intrinsic nuclei connected to somatosensory and motor-premotor cortical regions. Using these nuclei as seed regions, the subsequent functional connectivity analysis highlighted an increase in patients' thalamocortical connectivity at rest. Additionally, the correlation between fALFF and polysomnographic data revealed a possible link between OSA severity and fALFF of regions belonging to the central autonomic network. CONCLUSIONS Our results suggest a hyperactivation in thalamic diurnal activity in patients with OSA syndrome, which we interpret as a possible consequence of increased thalamocortical circuitry activation during nighttime due to repeated arousals.
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Affiliation(s)
- Emiliano Santarnecchi
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Giulia Sprugnoli
- Siena Brain Investigation & Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy
| | - Isabella Sicilia
- Center for Sleep Study, University of Siena School of Medicine, Siena, Italy
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Centre Jülich, Jülich, Germany,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Francesco Neri
- Siena Brain Investigation & Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy
| | - Sara M. Romanella
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA,Siena Brain Investigation & Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy
| | - Alfonso Cerase
- Department of Medicine, Surgery and Neuroscience, Section of Neuroradiology, University of Siena, Siena, Italy
| | - Giampaolo Vatti
- Center for Sleep Study, University of Siena School of Medicine, Siena, Italy
| | - Raffaele Rocchi
- Center for Sleep Study, University of Siena School of Medicine, Siena, Italy
| | - Alessandro Rossi
- Siena Brain Investigation & Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Unit, University of Siena, Siena, Italy,Center for Sleep Study, University of Siena School of Medicine, Siena, Italy
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13
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Smith JC. Respiratory rhythm and pattern generation: Brainstem cellular and circuit mechanisms. HANDBOOK OF CLINICAL NEUROLOGY 2022; 188:1-35. [PMID: 35965022 DOI: 10.1016/b978-0-323-91534-2.00004-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Breathing movements in mammals are driven by rhythmic neural activity automatically generated within spatially and functionally organized brainstem neural circuits comprising the respiratory central pattern generator (CPG). This chapter reviews up-to-date experimental information and theoretical studies of the cellular and circuit mechanisms of respiratory rhythm and pattern generation operating within critical components of this CPG in the lower brainstem. Over the past several decades, there have been substantial advances in delineating the spatial architecture of essential medullary regions and their regional cellular and circuit properties required to understand rhythm and pattern generation mechanisms. A fundamental concept is that the circuits in these regions have rhythm-generating capabilities at multiple cellular and circuit organization levels. The regional cellular properties, circuit organization, and control mechanisms allow flexible expression of neural activity patterns for a repertoire of respiratory behaviors under various physiologic conditions that are dictated by requirements for homeostatic regulation and behavioral integration. Many mechanistic insights have been provided by computational modeling studies driven by experimental results and have advanced understanding in the field. These conceptual and theoretical developments are discussed.
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Affiliation(s)
- Jeffrey C Smith
- Cellular and Systems Neurobiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.
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14
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Abstract
The clinical term dyspnea (a.k.a. breathlessness or shortness of breath) encompasses at least three qualitatively distinct sensations that warn of threats to breathing: air hunger, effort to breathe, and chest tightness. Air hunger is a primal homeostatic warning signal of insufficient alveolar ventilation that can produce fear and anxiety and severely impacts the lives of patients with cardiopulmonary, neuromuscular, psychological, and end-stage disease. The sense of effort to breathe informs of increased respiratory muscle activity and warns of potential impediments to breathing. Most frequently associated with bronchoconstriction, chest tightness may warn of airway inflammation and constriction through activation of airway sensory nerves. This chapter reviews human and functional brain imaging studies with comparison to pertinent neurorespiratory studies in animals to propose the interoceptive networks underlying each sensation. The neural origins of their distinct sensory and affective dimensions are discussed, and areas for future research are proposed. Despite dyspnea's clinical prevalence and impact, management of dyspnea languishes decades behind the treatment of pain. The neurophysiological bases of current therapeutic approaches are reviewed; however, a better understanding of the neural mechanisms of dyspnea may lead to development of novel therapies and improved patient care.
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Affiliation(s)
- Andrew P Binks
- Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States; Faculty of Health Sciences, Virginia Tech, Blacksburg, VA, United States.
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15
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Noto T, Zhou G, Yang Q, Lane G, Zelano C. Human Primary Olfactory Amygdala Subregions Form Distinct Functional Networks, Suggesting Distinct Olfactory Functions. Front Syst Neurosci 2021; 15:752320. [PMID: 34955769 PMCID: PMC8695617 DOI: 10.3389/fnsys.2021.752320] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/08/2021] [Indexed: 12/02/2022] Open
Abstract
Three subregions of the amygdala receive monosynaptic projections from the olfactory bulb, making them part of the primary olfactory cortex. These primary olfactory areas are located at the anterior-medial aspect of the amygdala and include the medial amygdala (MeA), cortical amygdala (CoA), and the periamygdaloid complex (PAC). The vast majority of research on the amygdala has focused on the larger basolateral and basomedial subregions, which are known to be involved in implicit learning, threat responses, and emotion. Fewer studies have focused on the MeA, CoA, and PAC, with most conducted in rodents. Therefore, our understanding of the functions of these amygdala subregions is limited, particularly in humans. Here, we first conducted a review of existing literature on the MeA, CoA, and PAC. We then used resting-state fMRI and unbiased k-means clustering techniques to show that the anatomical boundaries of human MeA, CoA, and PAC accurately parcellate based on their whole-brain resting connectivity patterns alone, suggesting that their functional networks are distinct, relative both to each other and to the amygdala subregions that do not receive input from the olfactory bulb. Finally, considering that distinct functional networks are suggestive of distinct functions, we examined the whole-brain resting network of each subregion and speculated on potential roles that each region may play in olfactory processing. Based on these analyses, we speculate that the MeA could potentially be involved in the generation of rapid motor responses to olfactory stimuli (including fight/flight), particularly in approach/avoid contexts. The CoA could potentially be involved in olfactory-related reward processing, including learning and memory of approach/avoid responses. The PAC could potentially be involved in the multisensory integration of olfactory information with other sensory systems. These speculations can be used to form the basis of future studies aimed at clarifying the olfactory functions of these under-studied primary olfactory areas.
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Affiliation(s)
- Torben Noto
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Guangyu Zhou
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Qiaohan Yang
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Gregory Lane
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Christina Zelano
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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16
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Kluger DS, Gross J. Respiration modulates oscillatory neural network activity at rest. PLoS Biol 2021; 19:e3001457. [PMID: 34762645 PMCID: PMC8610250 DOI: 10.1371/journal.pbio.3001457] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/23/2021] [Accepted: 10/25/2021] [Indexed: 12/11/2022] Open
Abstract
Despite recent advances in understanding how respiration affects neural signalling to influence perception, cognition, and behaviour, it is yet unclear to what extent breathing modulates brain oscillations at rest. We acquired respiration and resting state magnetoencephalography (MEG) data from human participants to investigate if, where, and how respiration cyclically modulates oscillatory amplitudes (2 to 150 Hz). Using measures of phase-amplitude coupling, we show respiration-modulated brain oscillations (RMBOs) across all major frequency bands. Sources of these modulations spanned a widespread network of cortical and subcortical brain areas with distinct spectrotemporal modulation profiles. Globally, delta and gamma band modulations varied with distance to the head centre, with stronger modulations at distal (versus central) cortical sites. Overall, we provide the first comprehensive mapping of RMBOs across the entire brain, highlighting respiration-brain coupling as a fundamental mechanism to shape neural processing within canonical resting state and respiratory control networks (RCNs).
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Affiliation(s)
- Daniel S. Kluger
- Institute for Biomagnetism and Biosignal Analysis, University of Muenster, Muenster, Germany
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
- * E-mail:
| | - Joachim Gross
- Institute for Biomagnetism and Biosignal Analysis, University of Muenster, Muenster, Germany
- Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
- Centre for Cognitive Neuroimaging, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
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17
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Palkovic B, Marchenko V, Zuperku EJ, Stuth EAE, Stucke AG. Multi-Level Regulation of Opioid-Induced Respiratory Depression. Physiology (Bethesda) 2021; 35:391-404. [PMID: 33052772 DOI: 10.1152/physiol.00015.2020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Opioids depress minute ventilation primarily by reducing respiratory rate. This results from direct effects on the preBötzinger Complex as well as from depression of the Parabrachial/Kölliker-Fuse Complex, which provides excitatory drive to preBötzinger Complex neurons mediating respiratory phase-switch. Opioids also depress awake drive from the forebrain and chemodrive.
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Affiliation(s)
- Barbara Palkovic
- Medical College of Wisconsin, Milwaukee, Wisconsin.,Faculty of Medicine, University of Osijek, Osijek, Croatia
| | | | - Edward J Zuperku
- Medical College of Wisconsin, Milwaukee, Wisconsin.,Zablocki VA Medical Center, Milwaukee, Wisconsin
| | - Eckehard A E Stuth
- Medical College of Wisconsin, Milwaukee, Wisconsin.,Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Astrid G Stucke
- Medical College of Wisconsin, Milwaukee, Wisconsin.,Children's Hospital of Wisconsin, Milwaukee, Wisconsin
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18
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Kassinopoulos M, Mitsis GD. Physiological noise modeling in fMRI based on the pulsatile component of photoplethysmograph. Neuroimage 2021; 242:118467. [PMID: 34390877 DOI: 10.1016/j.neuroimage.2021.118467] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/21/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
The blood oxygenation level-dependent (BOLD) contrast mechanism allows the noninvasive monitoring of changes in deoxyhemoglobin content. As such, it is commonly used in functional magnetic resonance imaging (fMRI) to study brain activity since levels of deoxyhemoglobin are indirectly related to local neuronal activity through neurovascular coupling mechanisms. However, the BOLD signal is severely affected by physiological processes as well as motion. Due to this, several noise correction techniques have been developed to correct for the associated confounds. The present study focuses on cardiac pulsatility fMRI confounds, aiming to refine model-based techniques that utilize the photoplethysmograph (PPG) signal. Specifically, we propose a new technique based on convolution filtering, termed cardiac pulsatility model (CPM) and compare its performance with the cardiac-related RETROICOR (Card-RETROICOR), which is a technique commonly used to model fMRI fluctuations due to cardiac pulsatility. Further, we investigate whether variations in the amplitude of the PPG pulses (PPG-Amp) covary with variations in amplitude of pulse-related fMRI fluctuations, as well as with the systemic low frequency oscillations (SLFOs) component of the fMRI global signal (GS - defined as the mean signal across all gray matter voxels). Capitalizing on 3T fMRI data from the Human Connectome Project, CPM was found to explain a significantly larger fraction of the fMRI signal variance compared to Card-RETROICOR, particularly for subjects with larger heart rate variability during the scan. The amplitude of the fMRI pulse-related fluctuations did not covary with PPG-Amp; however, PPG-Amp explained significant variance in the GS that was not attributed to variations in heart rate or breathing patterns. Our results suggest that the proposed approach can model high-frequency fluctuations due to pulsation as well as low-frequency physiological fluctuations more accurately compared to model-based techniques commonly employed in fMRI studies.
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Affiliation(s)
- Michalis Kassinopoulos
- Graduate Program in Biological and Biomedical Engineering, McGill University, Montreal, QC, Canada.
| | - Georgios D Mitsis
- Department of Bioengineering, McGill University, Montreal, QC, Canada
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19
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Cauzzo S, Callara AL, Morelli MS, Hartwig V, Esposito F, Montanaro D, Passino C, Emdin M, Giannoni A, Vanello N. Mapping dependencies of BOLD signal change to end-tidal CO 2: linear and nonlinear modeling, and effect of physiological noise correction. J Neurosci Methods 2021; 362:109317. [PMID: 34380051 DOI: 10.1016/j.jneumeth.2021.109317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/28/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Disentangling physiological noise and signal of interest is a major issue when evaluating BOLD-signal changes in response to breath holding. Currently-adopted approaches for retrospective noise correction are general-purpose, and have non-negligible effects in studies on hypercapnic challenges. NEW METHOD We provide a novel approach to the analysis of specific and non-specific BOLD-signal changes related to end-tidal CO2 (PETCO2) in breath-hold fMRI studies. Multiple-order nonlinear predictors for PETCO2 model a region-dependent nonlinear input-output relationship hypothesized in literature and possibly playing a crucial role in disentangling noise. We explore Retrospective Image-based Correction (RETROICOR) effects on the estimated BOLD response, applying our analysis both with and without RETROICOR and analyzing the linear and non-linear correlation between PETCO2 and RETROICOR regressors. RESULTS The RETROICOR model of noise related to respiratory activity correlated with PETCO2 both linearly and non-linearly. The correction affected the shape of the estimated BOLD response to hypercapnia but allowed to discard spurious activity in ventricles and white matter. Activation clusters were best detected using non-linear components in the BOLD response model. COMPARISON WITH EXISTING METHOD We evaluated the side-effects of standard physiological noise correction procedure, tailoring our analysis on challenging understudied brainstem and subcortical regions. Our novel approach allowed to characterize delays and non-linearities in BOLD response. CONCLUSIONS RETROICOR successfully avoided false positives, still broadly affecting the estimated non-linear BOLD responses. Non-linearities in the model better explained CO2-related BOLD signal fluctuations. The necessity to modify the standard procedure for physiological-noise correction in breath-hold studies was addressed, stating its crucial importance.
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Affiliation(s)
- Simone Cauzzo
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy.
| | | | - Maria Sole Morelli
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Valentina Hartwig
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Fabrizio Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | | | - Claudio Passino
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Michele Emdin
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Alberto Giannoni
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Nicola Vanello
- Dipartimento di Ingegneria dell'Informazione, University of Pisa, Pisa, Italy
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20
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Zhang Y, Kong Y, Yang Y, Yin Y, Hou Z, Xu Z, Yuan Y. Asthma-Specific Temporal Variability Reveals the Effect of Group Cognitive Behavior Therapy in Asthmatic Patients. Front Neurol 2021; 12:615820. [PMID: 33776882 PMCID: PMC7994749 DOI: 10.3389/fneur.2021.615820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Group cognitive behavior therapy (GCBT) is a successful therapy for asthma. However, the neural biomarker of GCBT which could be used in clinic remains unclear. The temporal variability is a novel concept to characterize the dynamic functional connectivity (FC), which has many advantages as biomarker. Therefore, the aim of this study is to explore the potential difference of temporal variability between asthmatic patients and healthy controls, then determine the different patterns of temporal variability between pre- and post-treatment group and reveal the relationship between the variability and the symptoms improvement reduced by GCBT. Methods: At baseline, 40 asthmatic patients and 40 matched controls received resting-state functional magnetic resonance imaging (fMRI) scans and clinical assessments. After 8 weeks of GCBT treatment, 17 patients received fMRI scans, and assessments again. Temporal variability at baseline and post-treatment were calculated for further analysis. Results: Compared with controls, asthmatic patients showed widespread decreases in temporal variability. Moreover, the variability in both right caudate and left putamen were positively correlated with asthma control level. After GCBT, asthma control level and depression of patients were improved. Meanwhile, compared with pre-GCBT, patients after treatment showed lower variability in left opercular of Rolandic, right parahippocampal gyrus and right lingual gyrus, as well as higher variability in left temporal pole. Variability in regions which were found abnormal at baseline did not exhibit significant differences between post-GCBT and controls. Conclusions: Asthma-specific changes of dynamic functional connectivity may serve as promising underpinnings of GCBT for asthma. Clinical Trial Registration: http://www.chictr.org.cn/index.aspx, identifier: Chi-CTR-15007442.
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Affiliation(s)
- Yuqun Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.,Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Youyong Kong
- Lab of Image Science and Technology, Key Laboratory of Computer Network and Information Integration, School of Computer Science and Engineering, Ministry of Education, Southeast University, Nanjing, China
| | - Yuan Yang
- Department of Respiratory, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingyin Yin
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhi Xu
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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21
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AlSalahi SE, Junejo RT, Bradley C, Balanos GM, Siebenmann C, Fisher JP. The middle cerebral artery blood velocity response to acute normobaric hypoxia occurs independently of changes in ventilation in humans. Exp Physiol 2021; 106:861-867. [PMID: 33527604 DOI: 10.1113/ep089127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/28/2021] [Indexed: 12/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? Does the ventilatory response to moderate acute hypoxia increase cerebral perfusion independently of changes in arterial oxygen tension in humans? What is the main finding and its importance? The ventilatory response does not increase middle cerebral artery mean blood velocity during moderate isocapnic acute hypoxia beyond that elicited by reduced oxygen saturation. ABSTRACT Hypoxia induces ventilatory, cardiovascular and cerebrovascular adjustments to defend against reductions in systemic oxygen delivery. We aimed to determine whether the ventilatory response to moderate acute hypoxia increases cerebral perfusion independently of changes in arterial oxygenation. Eleven young healthy individuals were exposed to four 15 min experimental conditions: (1) normoxia (partial pressure of end-tidal oxygen, P ET O 2 = 100 mmHg), (2) hypoxia ( P ET O 2 = 50 mmHg), (3) normoxia with breathing volitionally matched to levels observed during hypoxia (hyperpnoea; P ET O 2 = 100 mmHg) and (4) hypoxia ( P ET O 2 = 50 mmHg) with respiratory frequency and tidal volume volitionally matched to levels observed during normoxia (i.e., restricted breathing (RB)). Isocapnia was maintained in all conditions. Middle cerebral artery mean blood velocity (MCA Vmean ), assessed by transcranial Doppler ultrasound, was increased during hypoxia (58 ± 12 cm/s, P = 0.04) and hypoxia + RB (61 ± 14 cm/s, P < 0.001) compared to normoxia (55 ± 11 cm/s), while it was unchanged during hyperpnoea (52 ± 13 cm/s, P = 0.08). MCA Vmean was not different between hypoxia and hypoxia + RB (P > 0.05). These findings suggest that the hypoxic ventilatory response does not increase cerebral perfusion, indexed using MCA Vmean , during moderate isocapnic acute hypoxia beyond that elicited by reduced oxygen saturation.
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Affiliation(s)
- Sultan E AlSalahi
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Rehan T Junejo
- Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Chris Bradley
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - George M Balanos
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | | | - James P Fisher
- Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
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22
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The neuronal associations of respiratory-volume variability in the resting state. Neuroimage 2021; 230:117783. [PMID: 33516896 DOI: 10.1016/j.neuroimage.2021.117783] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/22/2020] [Accepted: 01/12/2021] [Indexed: 12/14/2022] Open
Abstract
The desire to enhance the sensitivity and specificity of resting-state (rs-fMRI) measures has prompted substantial recent research into removing noise components. Chief among contributions to noise in rs-fMRI are physiological processes, and the neuronal implications of respiratory-volume variability (RVT), a main rs-fMRI-relevant physiological process, is incompletely understood. The potential implications of RVT in modulating and being modulated by autonomic nervous regulation, has yet to be fully understood by the rs-fMRI community. In this work, we use high-density electroencephalography (EEG) along with simultaneously acquired RVT recordings to help address this question. We hypothesize that (1) there is a significant relationship between EEG and RVT in multiple EEG bands, and (2) that this relationship varies by brain region. Our results confirm our first hypothesis, although all brain regions are shown to be equally implicated in RVT-related EEG-signal fluctuations. The lag between RVT and EEG is consistent with previously reported values. However, an interesting finding is related to the polarity of the correlation between RVT and EEG. Our results reveal potentially two main regimes of EEG-RVT association, one in which EEG leads RVT with a positive association between the two, and one in which RVT leads EEG but with a negative association between the two. We propose that these two patterns can be interpreted differently in terms of the involvement of higher cognition. These results further suggest that treating RVT simply as noise is likely a questionable practice, and that more work is needed to avoid discarding cognitively relevant information when performing physiological correction rs-fMRI.
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23
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Lavretsky H, Feldman PhD JL. Precision Medicine for Breath-Focused Mind-Body Therapies for Stress and Anxiety: Are We Ready Yet? Glob Adv Health Med 2021; 10:2164956120986129. [PMID: 33489480 PMCID: PMC7809295 DOI: 10.1177/2164956120986129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/05/2020] [Accepted: 12/16/2020] [Indexed: 11/16/2022] Open
Abstract
In this viewpoint, we present an argument for transdisciplinary "precision medicine" approaches that combine studies of basic neurobiology of breathing in animal and human models of stress that can help characterize physiological and neural biomarkers and mechanisms of breathing control and emotion regulation in humans. Such mechanistic research is fundamental for the development of more effective and mechanism-based mind-body therapies. The potential for this research to positively impact public health is high, as breathing techniques are inexpensive, accessible, and cross-culturally accepted, with fewer complications then observed with other standard therapies for stress-related disorders.
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Affiliation(s)
- Helen Lavretsky
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, California
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24
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Holton P, Huang Y, Bahuri NFA, Boccard S, Hyam JA, Paterson DJ, Dorrington KL, Aziz TZ, Moosavi SH, Green AL. Differential responses to breath-holding, voluntary deep breathing and hypercapnia in left and right dorsal anterior cingulate. Exp Physiol 2020; 106:726-735. [PMID: 33369804 DOI: 10.1113/ep088961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/22/2020] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? What is the role of dorsal anterior cingulate cortex (ACC) in respiration control in humans? What is the main finding and its importance? Direct evidence is provided for a role of the ACC in respiratory control in humans. The neurophysiological responses in dorsal ACC to different breathing tasks varied and were different between left and right ACC. ABSTRACT The role of subcortical structures and cerebral cortex in the maintenance of respiratory homeostasis in humans remains poorly understood. Emerging evidence suggests an important role of the anterior cingulate cortex (ACC) in respiratory control. In this study, local field potentials (LFPs) from dorsal ACC were recorded in humans through implanted deep brain electrodes during several breathing activities, including voluntary activities of breath-holding and deep breathing, and involuntary activities of inspiration of varying concentrations of carbon dioxide (1%, 3%, 5% and 7%). We found that the breath-holding task induced significant unilateral left-sided ACC changes in LFP power, including an increased activity in lower frequency bands (3-5 Hz) and decreased activity in higher frequency bands (12-26 Hz). The respiratory task involving reflex increase in ventilation due to hypercapnia (raised inspired CO2 ) was associated with bilateral changes in activity of the ACC (again with increased activity in lower frequency bands and reduced activity in higher frequency bands). The voluntary breathing task with associated hypocapnia (deep breathing) induced bilateral changes in activity within low frequency bands. Furthermore, probabilistic diffusion tractography analysis showed left-sided connection of the ACC with the insula and frontal operculum, and bilateral connections within subsections of the cingulate gyrus and the thalamus. This electrophysiological analysis provides direct evidence for a role of the ACC in respiratory control in humans.
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Affiliation(s)
- Patrick Holton
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Yongzhi Huang
- Tianjin International Joint Research Center for Neural Engineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | | | - Sandra Boccard
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Jonathan A Hyam
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - David J Paterson
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Keith L Dorrington
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Tipu Z Aziz
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Shakeeb H Moosavi
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK
| | - Alexander L Green
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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25
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Abstract
Blood oxygen level dependent (BOLD) fMRI is a common technique for measuring brain activation that could be affected by low-level carbon monoxide (CO) exposure from, e.g. smoking. This study aimed to probe the vulnerability of BOLD fMRI to CO and determine whether it may constitute a significant neuroimaging confound. Low-level (6 ppm exhaled) CO effects on BOLD response were assessed in 12 healthy never-smokers on two separate experimental days (CO and air control). fMRI tasks were breath-holds (hypercapnia), visual stimulation and fingertapping. BOLD fMRI response was lower during breath holds, visual stimulation and fingertapping in the CO protocol compared to the air control protocol. Behavioural and physiological measures remained unchanged. We conclude that BOLD fMRI might be vulnerable to changes in baseline CO, and suggest exercising caution when imaging populations exposed to elevated CO levels. Further work is required to fully elucidate the impact on CO on fMRI and its underlying mechanisms.
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Affiliation(s)
- Caroline Bendell
- Biological and Medical Sciences, Oxford Brookes University, Oxford, UK
| | - Shakeeb H Moosavi
- Biological and Medical Sciences, Oxford Brookes University, Oxford, UK
| | - Mari Herigstad
- Biomolecular Sciences Research Centre, Department of Biosciences and Chemistry, Sheffield Hallam University, Sheffield, UK
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26
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Rushmore RJ, Wilson-Braun P, Papadimitriou G, Ng I, Rathi Y, Zhang F, O'Donnell LJ, Kubicki M, Bouix S, Yeterian E, Lemaire JJ, Calabrese E, Johnson GA, Kikinis R, Makris N. 3D Exploration of the Brainstem in 50-Micron Resolution MRI. Front Neuroanat 2020; 14:40. [PMID: 33071761 PMCID: PMC7538715 DOI: 10.3389/fnana.2020.00040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/16/2020] [Indexed: 12/25/2022] Open
Abstract
The brainstem, a structure of vital importance in mammals, is currently becoming a principal focus in cognitive, affective, and clinical neuroscience. Midbrain, pontine and medullary structures serve as the conduit for signals between the forebrain and spinal cord, are the epicenter of cranial nerve-circuits and systems, and subserve such integrative functions as consciousness, emotional processing, pain, and motivation. In this study, we parcellated the nuclear masses and the principal fiber pathways that were visible in a high-resolution T2-weighted MRI dataset of 50-micron isotropic voxels of a postmortem human brainstem. Based on this analysis, we generated a detailed map of the human brainstem. To assess the validity of our maps, we compared our observations with histological maps of traditional human brainstem atlases. Given the unique capability of MRI-based morphometric analysis in generating and preserving the morphology of 3D objects from individual 2D sections, we reconstructed the motor, sensory and integrative neural systems of the brainstem and rendered them in 3D representations. We anticipate the utilization of these maps by the neuroimaging community for applications in basic neuroscience as well as in neurology, psychiatry, and neurosurgery, due to their versatile computational nature in 2D and 3D representations in a publicly available capacity.
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Affiliation(s)
- Richard Jarrett Rushmore
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States.,Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States
| | - Peter Wilson-Braun
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States.,Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States
| | - George Papadimitriou
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
| | - Isaac Ng
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
| | - Yogesh Rathi
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States.,Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Laboratory for Mathematics and Imaging, Brigham and Women's Hospital, Boston, MA, United States.,Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States
| | - Lauren Jean O'Donnell
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Laboratory for Mathematics and Imaging, Brigham and Women's Hospital, Boston, MA, United States.,Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States
| | - Marek Kubicki
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States.,Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sylvain Bouix
- Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States
| | - Edward Yeterian
- Department of Psychology, Colby College, Waterville, ME, United States
| | - Jean-Jacques Lemaire
- Service de Neurochirurgie, CHU Clermont-Ferrand, Universite Clermont Auvergne, CNRS, SIGMA Clermont, Clermont-Ferrand, France
| | - Evan Calabrese
- Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, United States
| | - G Allan Johnson
- Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Durham, NC, United States
| | - Ron Kikinis
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States.,Computer Science Department, University of Bremen, Institutsleiter, Fraunhofer MEVIS, Bremen, Germany
| | - Nikos Makris
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States.,Psychiatric Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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27
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Prabhakar A, Sivadasan A, Shaikh A, Aaron S, Benjamin R, Mani AM, Mathew V. Network Localization of Central Hypoventilation Syndrome in Lateral Medullary Infarction. J Neuroimaging 2020; 30:875-881. [DOI: 10.1111/jon.12765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Ajith Sivadasan
- Department of Neurological Sciences Christian Medical College Vellore India
| | - Atif Shaikh
- Department of Neurological Sciences Christian Medical College Vellore India
| | - Sanjith Aaron
- Department of Neurological Sciences Christian Medical College Vellore India
| | - Rohit Benjamin
- Department of Neurological Sciences Christian Medical College Vellore India
| | - Arun Mathai Mani
- Department of Neurological Sciences Christian Medical College Vellore India
| | - Vivek Mathew
- Department of Neurological Sciences Christian Medical College Vellore India
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28
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Patodia S, Tachrount M, Somani A, Scheffer I, Yousry T, Golay X, Sisodiya SM, Thom M. MRI and pathology correlations in the medulla in sudden unexpected death in epilepsy (SUDEP): a postmortem study. Neuropathol Appl Neurobiol 2020; 47:157-170. [PMID: 32559314 DOI: 10.1111/nan.12638] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 06/10/2020] [Indexed: 12/21/2022]
Abstract
AIMS Sudden unexpected death in epilepsy (SUDEP) likely arises as a result of autonomic dysfunction around the time of a seizure. In vivo MRI studies report volume reduction in the medulla and other brainstem autonomic regions. Our aim, in a pathology series, is to correlate regional quantitative features on 9.4T MRI with pathology measures in medullary regions. METHODS Forty-seven medullae from 18 SUDEP, 18 nonepilepsy controls and 11 epilepsy controls were studied. In 16 cases, representing all three groups, ex vivo 9.4T MRI of the brainstem was carried out. Five regions of interest (ROI) were delineated, including the reticular formation zone (RtZ), and actual and relative volumes (RV), as well as T1, T2, T2* and magnetization transfer ratio (MTR) measurements were evaluated on MRI. On serial sections, actual and RV estimates using Cavalieri stereological method and immunolabelling indices for myelin basic protein, synaptophysin and Microtubule associated protein 2 (MAP2) were carried out in similar ROI. RESULTS Lower relative RtZ volumes in the rostral medulla but higher actual volumes in the caudal medulla were observed in SUDEP (P < 0.05). No differences between groups for T1, T2, T2* and MTR values in any region was seen but a positive correlation between T1 values and MAP2 labelling index in RtZ (P < 0.05). Significantly lower MAP2 LI were noted in the rostral medulla RtZ in epilepsy cases (P < 0.05). CONCLUSIONS Rostro-caudal alterations of medullary volume in SUDEP localize with regions containing respiratory regulatory nuclei. They may represent seizure-related alterations, relevant to the pathophysiology of SUDEP.
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Affiliation(s)
- S Patodia
- Department of Neuropathology, UCL Queen Square Institute of Neurology, London, UK.,Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - M Tachrount
- Neuroradiology Academic Unit, Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK.,FMRIB, Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - A Somani
- Department of Neuropathology, UCL Queen Square Institute of Neurology, London, UK.,Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - I Scheffer
- Department of Medicine (Neurology), Epilepsy Research Centre, University of Melbourne, Melbourne, VIC, Australia
| | - T Yousry
- Neuroradiology Academic Unit, Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - X Golay
- Neuroradiology Academic Unit, Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - S M Sisodiya
- Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - M Thom
- Department of Neuropathology, UCL Queen Square Institute of Neurology, London, UK.,Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
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29
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Tantirigama MLS, Zolnik T, Judkewitz B, Larkum ME, Sachdev RNS. Perspective on the Multiple Pathways to Changing Brain States. Front Syst Neurosci 2020; 14:23. [PMID: 32457583 PMCID: PMC7225277 DOI: 10.3389/fnsys.2020.00023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/06/2020] [Indexed: 11/13/2022] Open
Abstract
In this review article, we highlight several disparate ideas that are linked to changes in brain state (i.e., sleep to arousal, Down to Up, synchronized to de-synchronized). In any discussion of the brain state, we propose that the cortical pyramidal neuron has a central position. EEG recordings, which typically assess brain state, predominantly reflect the activity of cortical pyramidal neurons. This means that the dominant rhythmic activity that characterizes a particular brain state ultimately has to manifest globally across the pyramidal neuron population. During state transitions, it is the long-range connectivity of these neurons that broadcast the resultant changes in activity to many subcortical targets. Structures like the thalamus, brainstem/hypothalamic neuromodulatory systems, and respiratory systems can also strongly influence brain state, and for many decades we have been uncovering bidirectional pathways that link these structures to state changes in the cerebral cortex. More recently, movement and active behaviors have emerged as powerful drivers of state changes. Each of these systems involve different circuits distributed across the brain. Yet, for a system-wide change in brain state, there must be a collaboration between these circuits that reflects and perhaps triggers the transition between brain states. As we expand our understanding of how brain state changes, our current challenge is to understand how these diverse sets of circuits and pathways interact to produce the changes observed in cortical pyramidal neurons.
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Affiliation(s)
| | | | | | - Matthew E. Larkum
- Institut für Biologie, Neurocure Center for Excellence, Charité Universitätsmedizin Berlin & Humboldt Universität, Berlin, Germany
| | - Robert N. S. Sachdev
- Institut für Biologie, Neurocure Center for Excellence, Charité Universitätsmedizin Berlin & Humboldt Universität, Berlin, Germany
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30
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De Looze C, Williamson W, Hirst R, O'Connor J, Knight S, McCrory C, Carey D, Kenny R. Impaired orthostatic heart rate recovery is associated with smaller thalamic volume: Results from The Irish Longitudinal Study on Aging (
TILDA
). Hum Brain Mapp 2020; 41:3370-3378. [PMID: 32352604 PMCID: PMC7375046 DOI: 10.1002/hbm.25022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/01/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022] Open
Abstract
The thalamus is a central hub of the autonomic network and thalamic volume has been associated with high‐risk phenotypes for sudden cardiac death. Heart rate response to physiological stressors (e.g., standing) and the associated recovery patterns provide reliable indicators of both autonomic function and cardiovascular risk. Here we examine if thalamic volume may be a risk marker for impaired heart rate recovery in response to orthostatic challenge. The Irish Longitudinal Study on Aging involves a nationally representative sample of older individuals aged ≥50 years. Multimodal brain magnetic resonance imaging and orthostatic heart rate recovery were available for a cross‐sectional sample of 430 participants. Multivariable regression and linear mixed‐effects models were adjusted for head size, age, sex, education, body mass index, blood pressure, history of cardiovascular diseases and events, cardiovascular medication, diabetes mellitus, smoking, alcohol intake, timed up‐and‐go (a measure of physical frailty), physical exercise and depression. Smaller thalamic volume was associated with slower heart rate recovery (−1.4 bpm per 1 cm3 thalamic volume, 95% CI −2.01 to −0.82; p < .001). In multivariable analysis, participants with smaller thalamic volumes had a mean heart rate recovery −2.7 bpm slower than participants with larger thalamic volumes (95% CI −3.89 to −1.61; p < .001). Covariates associated with smaller thalamic volume included age, history of diabetes, and heavy alcohol consumption. Thalamic volume may be an indicator of the structural integrity of the central autonomic network. It may be a clinical biomarker for stratification of individuals at risk of autonomic dysfunction, cardiovascular events, and sudden cardiac death.
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Affiliation(s)
- Céline De Looze
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
| | - Wilby Williamson
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
- Department of PhysiologyTrinity College Dublin Dublin Ireland
- Global Brain Health Institute, Trinity College Dublin Dublin Ireland
- Oxford Cardiovascular Clinical Research Facility Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of Oxford Oxford UK
| | - Rebecca Hirst
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
- School of Psychology and Institute of Neuroscience, Trinity College Dublin Dublin Ireland
| | - John O'Connor
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
| | - Silvin Knight
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
| | - Daniel Carey
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
| | - Rose‐Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College, University of Dublin Dublin Ireland
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31
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Dhingra RR, Dick TE, Furuya WI, Galán RF, Dutschmann M. Volumetric mapping of the functional neuroanatomy of the respiratory network in the perfused brainstem preparation of rats. J Physiol 2020; 598:2061-2079. [PMID: 32100293 DOI: 10.1113/jp279605] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/05/2020] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS The functional neuroanatomy of the mammalian respiratory network is far from being understood since experimental tools that measure neural activity across this brainstem-wide circuit are lacking. Here, we use silicon multi-electrode arrays to record respiratory local field potentials (rLFPs) from 196-364 electrode sites within 8-10 mm3 of brainstem tissue in single arterially perfused brainstem preparations with respect to the ongoing respiratory motor pattern of inspiration (I), post-inspiration (PI) and late-expiration (E2). rLFPs peaked specifically at the three respiratory phase transitions, E2-I, I-PI and PI-E2. We show, for the first time, that only the I-PI transition engages a brainstem-wide network, and that rLFPs during the PI-E2 transition identify a hitherto unknown role for the dorsal respiratory group. Volumetric mapping of pontomedullary rLFPs in single preparations could become a reliable tool for assessing the functional neuroanatomy of the respiratory network in health and disease. ABSTRACT While it is widely accepted that inspiratory rhythm generation depends on the pre-Bötzinger complex, the functional neuroanatomy of the neural circuits that generate expiration is debated. We hypothesized that the compartmental organization of the brainstem respiratory network is sufficient to generate macroscopic local field potentials (LFPs), and if so, respiratory (r) LFPs could be used to map the functional neuroanatomy of the respiratory network. We developed an approach using silicon multi-electrode arrays to record spontaneous LFPs from hundreds of electrode sites in a volume of brainstem tissue while monitoring the respiratory motor pattern on phrenic and vagal nerves in the perfused brainstem preparation. Our results revealed the expression of rLFPs across the pontomedullary brainstem. rLFPs occurred specifically at the three transitions between respiratory phases: (1) from late expiration (E2) to inspiration (I), (2) from I to post-inspiration (PI), and (3) from PI to E2. Thus, respiratory network activity was maximal at respiratory phase transitions. Spatially, the E2-I, and PI-E2 transitions were anatomically localized to the ventral and dorsal respiratory groups, respectively. In contrast, our data show, for the first time, that the generation of controlled expiration during the post-inspiratory phase engages a distributed neuronal population within ventral, dorsal and pontine network compartments. A group-wise independent component analysis demonstrated that all preparations exhibited rLFPs with a similar temporal structure and thus share a similar functional neuroanatomy. Thus, volumetric mapping of rLFPs could allow for the physiological assessment of global respiratory network organization in health and disease.
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Affiliation(s)
- Rishi R Dhingra
- The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Australia
| | - Thomas E Dick
- Division of Pulmonary, Critical Care & Sleep, Department of Medicine, Case Western Reserve University, Cleveland, USA
| | - Werner I Furuya
- The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Australia
| | - Roberto F Galán
- Department of Electrical Engineering and Computer Science, Case Western Reserve University, Cleveland, USA
| | - Mathias Dutschmann
- The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Australia
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32
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Jehangir W, Karabachev AD, Mehta Z, Davis M. Opioid-Related Sleep-Disordered Breathing: An Update for Clinicians. Am J Hosp Palliat Care 2020; 37:970-973. [PMID: 32191115 DOI: 10.1177/1049909120913232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Opioids are an effective treatment for patients with intractable pain. Long-term administration of opioids for pain relief is being delivered by an increasing number of medical providers in the United States including primary care physicians and nonspecialists. One common complication of chronic opioid use is sleep-disordered breathing which can result in various morbidities as well as an increase in all-cause mortality. It is important for providers to understand the relationship between opioids and sleep-disordered breathing as well as methods to improve diagnosis and strategies for treatment. This review aims to update clinicians on the mechanism, diagnosis, and treatment of opioid-related sleep-disordered breathing in order to improve the quality of care for patients with chronic pain.
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Affiliation(s)
- Waqas Jehangir
- The University of Vermont Medical Center, Hematology and Medical Oncology, Burlington, VT, USA
| | - Alexander D Karabachev
- The University of Vermont College of Medicine, Larner College of Medicine, Burlington, VT, USA
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33
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McIntosh RC, Hoshi RA, Timpano KR. Take my breath away: Neural activation at breath-hold differentiates individuals with panic disorder from healthy controls. Respir Physiol Neurobiol 2020; 277:103427. [PMID: 32120012 DOI: 10.1016/j.resp.2020.103427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 02/12/2020] [Accepted: 02/24/2020] [Indexed: 01/04/2023]
Abstract
There is neuroanatomical evidence of an "extended fear network" of brain structures involved in the etiology of panic disorder (PD). Although ventilatory distrubance is a primary symptom of PD these sensations may also trigger onset of a panic attack (PA). Here, a voluntary breath-holding paradigm was used to mimic the hypercapnia state in order to compare blood oxygen level-dependent (BOLD) response, at the peak of a series of 18 s breath-holds, of 21 individuals with PD to 21 low anxiety matched controls. Compared to the rest condition, BOLD activity at the peak (12 - 18 s) of the breath-hold was greater for PD versus controls within a number of structures implicated in the extended fear network, including hippocampus, thalamus, and brainstem. Activation was also observed in cortical structures that are shown to be involved in interoceptive and self-referential processing, such as right insula, middle frontal gyrus, and precuneus/posterior cingulate. In lieu of amygdala activation, our findings show elevated activity throughout an extended network of cortical and subcortical structures involved in contextual, interoceptive and self-referential processing when individuals with PD engage in voluntary breath-holding.
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Affiliation(s)
- R C McIntosh
- Department of Psychology, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, United States.
| | - R A Hoshi
- Clinical and Epidemiological Research Center, Sao Paulo University. 2565 Professor Lineu Prestes Ave, Sao Paulo, 05508-000, Brazil
| | - K R Timpano
- Department of Psychology, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, United States
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34
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Singh K, Indovina I, Augustinack JC, Nestor K, García-Gomar MG, Staab JP, Bianciardi M. Probabilistic Template of the Lateral Parabrachial Nucleus, Medial Parabrachial Nucleus, Vestibular Nuclei Complex, and Medullary Viscero-Sensory-Motor Nuclei Complex in Living Humans From 7 Tesla MRI. Front Neurosci 2020; 13:1425. [PMID: 32038134 PMCID: PMC6989551 DOI: 10.3389/fnins.2019.01425] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/17/2019] [Indexed: 11/13/2022] Open
Abstract
The lateral parabrachial nucleus, medial parabrachial nucleus, vestibular nuclei complex, and medullary viscero-sensory-motor (VSM) nuclei complex (the latter including among others the solitary nucleus, vagus nerve nucleus, and hypoglossal nucleus) are anatomically and functionally connected brainstem gray matter structures that convey signals across multiple modalities between the brain and the spinal cord to regulate vital bodily functions. It is remarkably difficult to precisely extrapolate the location of these nuclei from ex vivo atlases to conventional 3 Tesla in vivo images; thus, a probabilistic brainstem template in stereotaxic neuroimaging space in living humans is needed. We delineated these nuclei using single-subject high contrast 1.1 mm isotropic resolution 7 Tesla MRI images. After precise coregistration of nuclei labels to stereotaxic space, we generated a probabilistic template of their anatomical locations. Finally, we validated the nuclei labels in the template by assessing their inter-rater agreement, consistency across subjects and volumes. We also performed a preliminary comparison of their location and microstructural properties to histologic sections of a postmortem human brainstem specimen. In future, the resulting probabilistic template of these brainstem nuclei in stereotaxic space may assist researchers and clinicians in evaluating autonomic, vestibular and VSM nuclei structure, function and connectivity in living humans using conventional 3 Tesla MRI scanners.
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Affiliation(s)
- Kavita Singh
- Brainstem Imaging Laboratory, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Iole Indovina
- Department of Medicine and Surgery, Saint Camillus International University of Health and Medical Sciences, Rome, Italy.,Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Jean C Augustinack
- Laboratory for Computational Neuroimaging, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Kimberly Nestor
- Laboratory for Computational Neuroimaging, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - María G García-Gomar
- Brainstem Imaging Laboratory, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Jeffrey P Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.,Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, MN, United States
| | - Marta Bianciardi
- Brainstem Imaging Laboratory, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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35
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Raitamaa L, Korhonen V, Huotari N, Raatikainen V, Hautaniemi T, Kananen J, Rasila A, Helakari H, Zienkiewicz A, Myllylä T, Borchardt V, Kiviniemi V. Breath hold effect on cardiovascular brain pulsations - A multimodal magnetic resonance encephalography study. J Cereb Blood Flow Metab 2019; 39:2471-2485. [PMID: 30204040 PMCID: PMC6893986 DOI: 10.1177/0271678x18798441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ultra-fast functional magnetic resonance encephalography (MREG) enables separate assessment of cardiovascular, respiratory, and vasomotor waves from brain pulsations without temporal aliasing. We examined effects of breath hold- (BH) related changes on cardiovascular brain pulsations using MREG to study the physiological nature of cerebrovascular reactivity. We used alternating 32 s BH and 88 s resting normoventilation (NV) to change brain pulsations during MREG combined with simultaneously measured respiration, continuous non-invasive blood pressure, and cortical near-infrared spectroscopy (NIRS) in healthy volunteers. Changes in classical resting-state network BOLD-like signal and cortical blood oxygenation were reproduced based on MREG and NIRS signals. Cardiovascular pulsation amplitudes of MREG signal from anterior cerebral artery, oxygenated hemoglobin concentration in frontal cortex, and blood pressure decreased after BH. MREG cardiovascular pulse amplitudes in cortical areas and sagittal sinus increased, while cerebrospinal fluid and white matter remained unchanged. Respiratory centers in the brainstem - hypothalamus - thalamus - amygdala network showed strongest increases in cardiovascular pulsation amplitude. The spatial propagation of averaged cardiovascular impulses altered as a function of successive BH runs. The spread of cardiovascular pulse cycles exhibited a decreasing spatial similarity over time. MREG portrayed spatiotemporally accurate respiratory network activity and cardiovascular pulsation dynamics related to BH challenges at an unpreceded high temporal resolution.
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Affiliation(s)
- Lauri Raitamaa
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Vesa Korhonen
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu, Finland
| | - Niko Huotari
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Ville Raatikainen
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Taneli Hautaniemi
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Janne Kananen
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Aleksi Rasila
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Heta Helakari
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Aleksandra Zienkiewicz
- Biomedical Sensors and Measurement Systems Group, Optoelectronics and Measurement Techniques Unit, University of Oulu, Oulu, Finland
| | - Teemu Myllylä
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland.,Biomedical Sensors and Measurement Systems Group, Optoelectronics and Measurement Techniques Unit, University of Oulu, Oulu, Finland
| | - Viola Borchardt
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland
| | - Vesa Kiviniemi
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu, Finland
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36
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Improving sensitivity, specificity, and reproducibility of individual brainstem activation. Brain Struct Funct 2019; 224:2823-2838. [PMID: 31435738 PMCID: PMC6778541 DOI: 10.1007/s00429-019-01936-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 08/07/2019] [Indexed: 12/20/2022]
Abstract
Functional imaging of the brainstem may open new avenues for clinical diagnostics. However, for reliable assessments of brainstem activation, further efforts improving signal quality are needed. Six healthy subjects performed four repeated functional magnetic resonance imaging (fMRI) sessions on different days with jaw clenching as a motor task to elicit activation in the trigeminal motor nucleus. Functional images were acquired with a 7 T MR scanner using an optimized multiband EPI sequence. Activation measures in the trigeminal nucleus and a control region were assessed using different physiological noise correction methods (aCompCor and RETROICOR-based approaches with variable numbers of regressors) combined with cerebrospinal fluid or brainstem masking. Receiver-operating characteristic analyses accounting for sensitivity and specificity, activation overlap analyses to estimate the reproducibility between sessions, and intraclass correlation analyses (ICC) for testing reliability between subjects and sessions were used to systematically compare the physiological noise correction approaches. Masking the brainstem led to increased activation in the target ROI and resulted in higher values for the area under the curve (AUC) as a combined measure for sensitivity and specificity. With the highest values for AUC, activation overlap, and ICC, the most favorable physiological noise correction method was to control for the cerebrospinal fluid time series (aCompCor with one regressor). Brainstem motor nuclei activation can be reliably identified using high-field fMRI with optimized acquisition and processing strategies—even on single-subject level. Applying specific physiological noise correction methods improves reproducibility and reliability of brainstem activation encouraging future clinical applications.
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37
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Patodia S, Somani A, O'Hare M, Venkateswaran R, Liu J, Michalak Z, Ellis M, Scheffer IE, Diehl B, Sisodiya SM, Thom M. The ventrolateral medulla and medullary raphe in sudden unexpected death in epilepsy. Brain 2019; 141:1719-1733. [PMID: 29608654 PMCID: PMC5972615 DOI: 10.1093/brain/awy078] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/01/2018] [Indexed: 11/14/2022] Open
Abstract
Sudden unexpected death in epilepsy (SUDEP) is a leading cause of premature death in patients with epilepsy. One hypothesis proposes that sudden death is mediated by post-ictal central respiratory depression, which could relate to underlying pathology in key respiratory nuclei and/or their neuromodulators. Our aim was to investigate neuronal populations in the ventrolateral medulla (which includes the putative human pre-Bötzinger complex) and the medullary raphe. Forty brainstems were studied comprising four groups: 14 SUDEP, six epilepsy controls, seven Dravet syndrome cases and 13 non-epilepsy controls. Serial sections through the medulla (from obex 1 to 10 mm) were stained for Nissl, somatostatin, neurokinin 1 receptor (for pre-Bötzinger complex neurons) and galanin, tryptophan hydroxylase and serotonin transporter (neuromodulatory systems). Using stereology total neuronal number and densities, with respect to obex level, were measured. Whole slide scanning image analysis was used to quantify immunolabelling indices as well as co-localization between markers. Significant findings included reduction in somatostatin neurons and neurokinin 1 receptor labelling in the ventrolateral medulla in sudden death in epilepsy compared to controls (P < 0.05). Galanin and tryptophan hydroxylase labelling was also reduced in sudden death cases and more significantly in the ventrolateral medulla region than the raphe (P < 0.005 and P < 0.05). With serotonin transporter, reduction in labelling in cases of sudden death in epilepsy was noted only in the raphe (P ≤ 0.01); however, co-localization with tryptophan hydroxylase was significantly reduced in the ventrolateral medulla. Epilepsy controls and cases with Dravet syndrome showed less significant alterations with differences from non-epilepsy controls noted only for somatostatin in the ventrolateral medulla (P < 0.05). Variations in labelling with respect to obex level were noted of potential relevance to the rostro-caudal organization of respiratory nuclear groups, including tryptophan hydroxylase, where the greatest statistical difference noted between all epilepsy cases and controls was at obex 9-10 mm (P = 0.034), the putative level of the pre-Bötzinger complex. Furthermore, there was evidence for variation with duration of epilepsy for somatostatin and neurokinin 1 receptor. Our findings suggest alteration to neuronal populations in the medulla in SUDEP with evidence for greater reduction in neuromodulatory neuropeptidergic and mono-aminergic systems, including for galanin, and serotonin. Other nuclei need to be investigated to evaluate if this is part of more widespread brainstem pathology. Our findings could be a result of previous seizures and may represent a pathological risk factor for SUDEP through impaired respiratory homeostasis during a seizure.
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Affiliation(s)
- Smriti Patodia
- Departments of Neuropathology, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Alyma Somani
- Departments of Neuropathology, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Megan O'Hare
- Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Ranjana Venkateswaran
- Departments of Neuropathology, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Joan Liu
- Departments of Neuropathology, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Department of Biomedical Sciences, University of Westminster London W1W 6UW, UK
| | - Zuzanna Michalak
- Departments of Neuropathology, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Matthew Ellis
- Departments of Neuropathology, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Ingrid E Scheffer
- Epilepsy Research Centre, Department of Medicine (Neurology), University of Melbourne, Victoria 3052, Australia
| | - Beate Diehl
- Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Sanjay M Sisodiya
- Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Maria Thom
- Departments of Neuropathology, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK.,Clinical and Experimental Epilepsy and Chalfont Centre for Epilepsy, UCL, Institute of Neurology, Queen Square, London WC1N 3BG, UK
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38
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Cauzzo S, Callara AL, Sole Morelli M, Hartwig V, Montanaro D, Passino C, Emdin M, Giannoni A, Vanello N. On the Use of Linear-Modelling-based Algorithms for Physiological Noise Correction in fMRI Studies of the Central Breathing Control. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:808-811. [PMID: 31946018 DOI: 10.1109/embc.2019.8856397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A full characterization of the physiological behavior of human central chemoreceptors through fMRI is crucial to understand the pathophysiology of central abnormal breathing patterns. In this scenario, physiological noise and activity of interest may be naturally correlated. Here, we examined the adequacy of linear-modelling-based retrospective physiological noise correction for studies of the central breathing control. We focused on the relationship between a nonlinear model of BOLD response, hypothesized to describe neuronal specific activity, and noise modelled by correction algorithms. Analyses were performed on fMRI acquisitions from healthy subjects during a breath hold task. A general linear model including static nonlinearities in the response to end-tidal CO2 was applied to data preprocessed both with and without physiological noise correction. Relations between physiological noise and PETCO2 were explored both with linear and nonlinear measures. Lastly, parametric maps of noise spatial distribution were extracted. Our results evidenced that correction algorithms based on linear modelling remove components that are both linearly and nonlinearly related to end-tidal CO2, whereas uncorrected data showed spurious activations in regions outside gray matter. Thus, despite a correction step is fundamental, these algorithms are shown to be over-conservative approaches to noise correction and need to be adapted to the specific purpose.
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39
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Callara AL, Vanello N, Sole Morelli M, Cauzzo S, Giannoni A, Hartwig V, Montanaro D, Landini L, Passino C, Emdin M. Exploring the supra linear relationship between PetCO2 and fMRI signal change with ICA. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:4795-4798. [PMID: 31946934 DOI: 10.1109/embc.2019.8856513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The relationships between brain functions and the respiratory system are complex. Disentangling brain activity related to CO2 changes from nonspecific vasoreactivity is a challenge when studying brain activity involved in the control of breathing with fMRI. In this work, we analyzed a dose dependent relationship between arterial CO2 levels and brain response. To accomplish this goal, we developed a gas administration protocol, together with multi-subject ICA and specific nonlinear post-processing analysis. Our results highlighted a supra-linear response to CO2 challenges in brainstem, thalamus and putamen. Results were discussed in the light of current knowledge about the central respiratory network.
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40
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Nguyen PB, Prentice D, Brazel R, Leong WK. Hemidysgeusia, phantosmia and respiratory arrest: a case of CLIPPERS. BMJ Case Rep 2019; 12:12/5/e230094. [PMID: 31151979 DOI: 10.1136/bcr-2019-230094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 56-year-old man presented with a relapse of likely chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) after a reduction of steroid dose. MRI demonstrated new perivascular FLuid-Attenuated Inversion Recovery (FLAIR) signal hyperintensity involving the dorsal pontomedullary junction and progressing inferiorly into the dorsal medulla oblongata. His admission to hospital was complicated by a respiratory arrest.
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Affiliation(s)
- Peter Baoviet Nguyen
- Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - David Prentice
- Perron Institute, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - Robert Brazel
- Neurological Intervention and Imaging Service of Western Australia, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - Wai Kuen Leong
- Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia
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41
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Tessa C, Toschi N, Orsolini S, Valenza G, Lucetti C, Barbieri R, Diciotti S. Central modulation of parasympathetic outflow is impaired in de novo Parkinson's disease patients. PLoS One 2019; 14:e0210324. [PMID: 30653564 PMCID: PMC6336270 DOI: 10.1371/journal.pone.0210324] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 12/20/2018] [Indexed: 01/09/2023] Open
Abstract
Task- and stimulus-based neuroimaging studies have begun to unveil the central autonomic network which modulates autonomic nervous system activity. In the present study, we aimed to evaluate the central autonomic network without the bias constituted by the use of a task. Additionally, we assessed whether this circuitry presents signs of dysregulation in the early stages of Parkinson’s disease (PD), a condition which may be associated with dysautonomia. We combined heart-rate-variability based methods for time-varying assessments of the autonomic nervous system outflow with resting-state fMRI in 14 healthy controls and 14 de novo PD patients, evaluating the correlations between fMRI time-series and the instantaneous high-frequency component of the heart-rate-variability power spectrum, a marker of parasympathetic outflow. In control subjects, the high-frequency component of the heart-rate-variability power spectrum was significantly anti-correlated with fMRI time-series in several cortical, subcortical and brainstem regions. This complex central network was not detectable in PD patients. In between-group analysis, we found that in healthy controls the brain activation related to the high-frequency component of the heart-rate-variability power spectrum was significantly less than in PD patients in the mid and anterior cingulum, sensorimotor cortex and supplementary motor area, insula and temporal lobe, prefrontal cortex, hippocampus and in a region encompassing posterior cingulum, precuneus and parieto-occipital cortex. Our results indicate that the complex central network which modulates parasympathetic outflow in the resting state is impaired in the early clinical stages of PD.
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Affiliation(s)
- Carlo Tessa
- Department of Radiology and Nuclear Medicine, Versilia Hospital, Azienda USL Toscana Nord Ovest, Lido di Camaiore (Lu), Italy
- * E-mail:
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States of America
| | - Stefano Orsolini
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Cesena, Italy
| | - Gaetano Valenza
- Department of Anesthesia, Massachusetts General Hospital, Boston, MA, United States of America
- Research Center E. Piaggio and Department of Information Engineering, School of Engineering, University of Pisa, Pisa, Italy
| | - Claudio Lucetti
- Division of Neurology, Versilia Hospital, Azienda USL Toscana Nord Ovest, Lido di Camaiore (Lu), Italy
| | - Riccardo Barbieri
- Department of Anesthesia, Massachusetts General Hospital, Boston, MA, United States of America
- Department of Electronics, Informatics and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, Cesena, Italy
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42
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Prokopiou PC, Pattinson KTS, Wise RG, Mitsis GD. Modeling of dynamic cerebrovascular reactivity to spontaneous and externally induced CO 2 fluctuations in the human brain using BOLD-fMRI. Neuroimage 2018; 186:533-548. [PMID: 30423427 DOI: 10.1016/j.neuroimage.2018.10.084] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/09/2018] [Accepted: 10/31/2018] [Indexed: 11/30/2022] Open
Abstract
In this work, we investigate the regional characteristics of the dynamic interactions between arterial CO2 and BOLD (dynamic cerebrovascular reactivity - dCVR) during normal breathing and hypercapnic, externally induced step CO2 challenges. To obtain dCVR curves at each voxel, we use a custom set of basis functions based on the Laguerre and gamma basis sets. This allows us to obtain robust dCVR estimates both in larger regions of interest (ROIs), as well as in individual voxels. We also implement classification schemes to identify brain regions with similar dCVR characteristics. Our results reveal considerable variability of dCVR across different brain regions, as well as during different experimental conditions (normal breathing and hypercapnic challenges), suggesting a differential response of cerebral vasculature to spontaneous CO2 fluctuations and larger, externally induced CO2 changes that are possibly associated with the underlying differences in mean arterial CO2 levels. The clustering results suggest that anatomically distinct brain regions are characterized by different dCVR curves that in some cases do not exhibit the standard, positive valued curves that have been previously reported. They also reveal a consistent set of dCVR cluster shapes for resting and forcing conditions, which exhibit different distribution patterns across brain voxels.
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Affiliation(s)
- Prokopis C Prokopiou
- Integrated Program in Neuroscience, McGill University, Montreal Neurological Institude, H3A 2B4, QC, Canada
| | - Kyle T S Pattinson
- Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Richard G Wise
- CUBRIC, School of Psychology, University of Cardiff, CF10 3AT, UK
| | - Georgios D Mitsis
- Department of Bioengineering, McGill Univesity, Montreal, QC, H3A 0C3, Canada; Integrated Program in Neuroscience, McGill University, Montreal Neurological Institude, H3A 2B4, QC, Canada.
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43
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Faull OK, Cox PJ, Pattinson KT. Cortical processing of breathing perceptions in the athletic brain. Neuroimage 2018; 179:92-101. [DOI: 10.1016/j.neuroimage.2018.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 01/14/2023] Open
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44
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Nikolaou F, Orphanidou C, Murphy K, Wise RG, Mitsis GD. Investigation Of Interaction Between Physiological Signals And fMRI Dynamic Functional Connectivity Using Independent Component Analysis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:1019-1023. [PMID: 30440564 DOI: 10.1109/embc.2018.8512465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The blood oxygen level dependent (BOLD) fMRI signal is influenced not only by neuronal activity but also by fluctuations in physiological signals, including respiration, arterial CO2 and heart rate/ heart rate variability (HR/HRV). Even spontaneous physiological signal fluctuations have been shown to influence the BOLD fMRI signal in a regionally specific manner. Consequently, estimates of functional connectivity between different brain regions, performed when the subject is at rest, may be confounded by the effects of physiological signal fluctuations. In addition, resting functional connectivity has been shown to vary with respect to time (dynamic functional connectivity - DFC), with the sources of this variation not fully elucidated. The effect of physiological factors on dynamic (time-varying) resting-state functional connectivity has not been studied extensively, to our knowledge. In our previous study, we investigated the effect of heart rate (HR) and end-tidal CO2 (PETCO2) on the time-varying network degree of three well-described RSNs (DMN, SMN and Visual Network) using mask-based and seed-based analysis, and we identified brain-heart interactions which were more pronounced in specific frequency bands. Here, we extend this work, by estimating DFC and its corresponding network degree for the RSNs, employing a data-driven approach to extract the RSNs (low-and high-dimensional Independent Component Analysis (ICA)), which we subsequently correlate with the characteristics of simultaneously collected physiological signals. The results confirm that physiological signals have a modulatory effect on resting-state, fMRI-based DFC.
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45
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Analysis of generic coupling between EEG activity and P ETCO 2 in free breathing and breath-hold tasks using Maximal Information Coefficient (MIC). Sci Rep 2018. [PMID: 29540714 PMCID: PMC5851981 DOI: 10.1038/s41598-018-22573-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Brain activations related to the control of breathing are not completely known. The respiratory system is a non-linear system. However, the relationship between neural and respiratory dynamics is usually estimated through linear correlation measures, completely neglecting possible underlying nonlinear interactions. This study evaluate the linear and nonlinear coupling between electroencephalographic (EEG) signal and variations in carbon dioxide (CO2) signal related to different breathing task. During a free breathing and a voluntary breath hold tasks, the coupling between EEG power in nine different brain regions in delta (1–3 Hz) and alpha (8–13 Hz) bands and end-tidal CO2 (PET CO2) was evaluated. Specifically, the generic associations (i.e. linear and nonlinear correlations) and a “pure” nonlinear correlations were evaluated using the maximum information coefficient (MIC) and MIC-ρ2 between the two signals, respectively (where ρ2 represents the Pearson’s correlation coefficient). Our results show that in delta band, MIC indexes discriminate the two tasks in several regions, while in alpha band the same behaviour is observed for MIC-ρ2, suggesting a generic coupling between delta EEG power and PETCO2 and a pure nonlinear interaction between alpha EEG power and PETCO2. Moreover, higher indexes values were found for breath hold task respect to free breathing.
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46
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Stevens D, Martins RT, Mukherjee S, Vakulin A. Post-Stroke Sleep-Disordered Breathing-Pathophysiology and Therapy Options. Front Surg 2018. [PMID: 29536012 PMCID: PMC5834929 DOI: 10.3389/fsurg.2018.00009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast improvements in post-stroke functional recovery outcomes after the treatment of SDB by continuous positive airway pressure. However, compliance to this therapy is very poor in this complex patient group. There are alternative therapy options for SDB that may be more amenable for use in at least some post-stroke patients, including mandibular advancement, supine avoidance, and oxygen therapy. There are few studies, however, that demonstrate efficacy and compliance with these alternative therapies currently. Furthermore, novel SDB-phenotyping approaches may help to provide important clinical information to direct therapy selection in individual patients. Prior to realizing individualized therapy, we need a better understanding of the pathophysiology of SDB in post-stroke patients, including the role of inherent phenotypic traits, as well as the contribution of stroke size and location. This review summarizes the available literature on SDB pathophysiology and treatment in post-stroke patients, identifies gaps in the literature, and sets out areas for further research.
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Affiliation(s)
- David Stevens
- A Flinders Centre of Research Excellence, College of Medicine and Public Health, Adelaide Institute for Sleep Health, Flinders University, Daw Park, SA, Australia
| | | | - Sutapa Mukherjee
- A Flinders Centre of Research Excellence, College of Medicine and Public Health, Adelaide Institute for Sleep Health, Flinders University, Daw Park, SA, Australia.,Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Andrew Vakulin
- A Flinders Centre of Research Excellence, College of Medicine and Public Health, Adelaide Institute for Sleep Health, Flinders University, Daw Park, SA, Australia.,The NHMRC Centre of Research Excellence, NEUROSLEEP, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
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Feldker K, Heitmann CY, Neumeister P, Brinkmann L, Bruchmann M, Zwitserlood P, Straube T. Cardiorespiratory concerns shape brain responses during automatic panic-related scene processing in patients with panic disorder. J Psychiatry Neurosci 2018; 43. [PMID: 29252163 PMCID: PMC5747532 DOI: 10.1503/jpn.160226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Increased automatic processing of threat-related stimuli has been proposed as a key element in panic disorder. Little is known about the neural basis of automatic processing, in particular to task-irrelevant, panic-related, ecologically valid stimuli, or about the association between brain activation and symptomatology in patients with panic disorder. METHODS The present event-related functional MRI (fMRI) study compared brain responses to task-irrelevant, panic-related and neutral visual stimuli in medication-free patients with panic disorder and healthy controls. Panic-related and neutral scenes were presented while participants performed a spatially nonoverlapping bar orientation task. Correlation analyses investigated the association between brain responses and panic-related aspects of symptomatology, measured using the Anxiety Sensitivity Index (ASI). RESULTS We included 26 patients with panic disorder and 26 heatlhy controls in our analysis. Compared with controls, patients with panic disorder showed elevated activation in the amygdala, brainstem, thalamus, insula, anterior cingulate cortex and midcingulate cortex in response to panic-related versus neutral task-irrelevant stimuli. Furthermore, fear of cardiovascular symptoms (a subcomponent of the ASI) was associated with insula activation, whereas fear of respiratory symptoms was associated with brainstem hyperactivation in patients with panic disorder. LIMITATIONS The additional implementation of measures of autonomic activation, such as pupil diameter, heart rate, or electrodermal activity, would have been informative during the fMRI scan as well as during the rating procedure. CONCLUSION Results reveal a neural network involved in the processing of panic-related distractor stimuli in patients with panic disorder and suggest an automatic weighting of panic-related information depending on the magnitude of cardiovascular and respiratory symptoms. Insula and brainstem activations show function-related associations with specific components of panic symptomatology.
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Affiliation(s)
- Katharina Feldker
- Correspondence to: K. Feldker, Institute of Medical Psychology and Systems Neuroscience, Von-Esmarch-Straße 52, D-48149 Muenster, Germany;
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Abnormal Functional Connectivity of Ventral Anterior Insula in Asthmatic Patients with Depression. Neural Plast 2017; 2017:7838035. [PMID: 28680706 PMCID: PMC5478859 DOI: 10.1155/2017/7838035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/24/2017] [Accepted: 04/09/2017] [Indexed: 12/15/2022] Open
Abstract
Objective To explore the underlying mechanism of depression in asthmatic patients, the ReHo in the insula and its FC was used to probe the differences between depressed asthmatic (DA) and nondepressed asthmatic (NDA) patients. Methods 18 DA patients, 24 NDA patients, and 60 healthy controls (HCs) received resting-state fMRI scan, severity of depression, and asthma control assessment. Results DA patients showed increased FC between the left ventral anterior insula (vAI) and the left middle temporal gyrus compared with both NDA and HC groups. In addition, compared with HCs, the DA and NDA patients both exhibited increased FC between the left vAI and the right anterior cingulate cortex (ACC), decreased FC between the left vAI and the bilateral parietal lobe, and increased FC between the right vAI and the left putamen and the right caudate, respectively. Furthermore, the increased FC between the left vAI and the right ACC could differentiate HCs from both DA and NDA patients, and the increased FC between the right vAI and both the left putamen and the right caudate could separate NDA patients from HCs. Conclusions This study confirmed that abnormal vAI FC may be involved in the neuropathology of depression in asthma. The increased FC between the left vAI and the left MTG could distinguish DA from the NDA and HC groups.
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Sclocco R, Beissner F, Bianciardi M, Polimeni JR, Napadow V. Challenges and opportunities for brainstem neuroimaging with ultrahigh field MRI. Neuroimage 2017; 168:412-426. [PMID: 28232189 DOI: 10.1016/j.neuroimage.2017.02.052] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/30/2017] [Accepted: 02/19/2017] [Indexed: 12/19/2022] Open
Abstract
The human brainstem plays a central role in connecting the cerebrum, the cerebellum and the spinal cord to one another, hosting relay nuclei for afferent and efferent signaling, and providing source nuclei for several neuromodulatory systems that impact central nervous system function. While the investigation of the brainstem with functional or structural magnetic resonance imaging has been hampered for years due to this brain structure's physiological and anatomical characteristics, the field has seen significant advances in recent years thanks to the broader adoption of ultrahigh-field (UHF) MRI scanning. In the present review, we focus on the advantages offered by UHF in the context of brainstem imaging, as well as the challenges posed by the investigation of this complex brain structure in terms of data acquisition and analysis. We also illustrate how UHF MRI can shed new light on the neuroanatomy and neurophysiology underlying different brainstem-based circuitries, such as the central autonomic network and neurotransmitter/neuromodulator systems, discuss existing and foreseeable clinical applications to better understand diseases such as chronic pain and Parkinson's disease, and explore promising future directions for further improvements in brainstem imaging using UHF MRI techniques.
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Affiliation(s)
- Roberta Sclocco
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, CNY 149-2301, 13th St. Charlestown, Boston, MA 02129, USA; Department of Radiology, Logan University, Chesterfield, MO, USA.
| | - Florian Beissner
- Somatosensory and Autonomic Therapy Research, Institute for Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Marta Bianciardi
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, CNY 149-2301, 13th St. Charlestown, Boston, MA 02129, USA
| | - Jonathan R Polimeni
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, CNY 149-2301, 13th St. Charlestown, Boston, MA 02129, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Vitaly Napadow
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, CNY 149-2301, 13th St. Charlestown, Boston, MA 02129, USA; Department of Radiology, Logan University, Chesterfield, MO, USA
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Faull OK, Pattinson KTS. The cortical connectivity of the periaqueductal gray and the conditioned response to the threat of breathlessness. eLife 2017; 6:e21749. [PMID: 28211789 PMCID: PMC5332157 DOI: 10.7554/elife.21749] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/13/2017] [Indexed: 01/15/2023] Open
Abstract
Previously we observed differential activation in individual columns of the periaqueductal grey (PAG) during breathlessness and its conditioned anticipation (Faull et al., 2016b). Here, we have extended this work by determining how the individual columns of the PAG interact with higher cortical centres, both at rest and in the context of breathlessness threat. Activation was observed in ventrolateral PAG (vlPAG) and lateral PAG (lPAG), where activity scaled with breathlessness intensity ratings, revealing a potential interface between sensation and cognition during breathlessness. At rest the lPAG was functionally correlated with cortical sensorimotor areas, conducive to facilitating fight/flight responses, and demonstrated increased synchronicity with the amygdala during breathlessness. The vlPAG showed fronto-limbic correlations at rest, whereas during breathlessness anticipation, reduced functional synchronicity was seen to both lPAG and motor structures, conducive to freezing behaviours. These results move us towards understanding how the PAG might be intricately involved in human responses to threat.
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Affiliation(s)
- Olivia K Faull
- FMRIB Centre, University of Oxford, Oxford, United Kingdom
- Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Kyle TS Pattinson
- FMRIB Centre, University of Oxford, Oxford, United Kingdom
- Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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