Key result
Inspiratory muscle training significantly decreased default mode network activation and increased insula activation compared to sham, with no significant change in respiratory rate (P=0.344).
Why the study?
Although inspiratory muscle training improves breath perception, the underlying brain mechanisms had not yet been studied.
Does inspiratory muscle training alter resting-state brain activity in healthy subjects?
RCT (n=26)
randomly assigned
Does inspiratory muscle training alter resting-state brain activity in healthy subjects?
Inspiratory muscle training alters resting-state brain activity in the insula and default mode network, potentially reflecting improved ventilatory perception.
Alters insula-DMN connectivity in healthy adults; hypothesis-generating for IMT mechanisms, requires confirmation in patients.
BACKGROUND: Although inspiratory muscle training (IMT) is an effective intervention for improving breath perception, brain mechanisms have not been studied yet. PURPOSE: To examine the effects of IMT on insula and default mode network (DMN) using resting-state functional MRI (RS-fMRI). STUDY TYPE: Prospective. POPULATION: A total of 26 healthy participants were randomly assigned to two groups as IMT group (n = 14) and sham IMT groups (n = 12). FIELD STRENGTH/SEQUENCE: A 3-T, three-dimensional T2* gradient-echo echo planar imaging sequence for RS-fMRI was obtained. ASSESSMENT: The intervention group received IMT at 60% and sham group received at 15% of maximal inspiratory pressure (MIP) for 8 weeks. Pulmonary and respiratory muscle function, and breathing patterns were measured. Groups underwent RS-fMRI before and after the treatment. STATISTICAL TESTS: Statistical tests were two-tailed P < 0.05 was considered statistically significant. Student's t test was used to compare the groups. One-sample t-test for each group was used to reveal pattern of functional connectivity. A statistical threshold of P < 0.001 uncorrected value was set at voxel level. We used False discovery rate (FDR)-corrected P < 0.05 cluster level. RESULTS: The IMT group showed more prominent alterations in insula and DMN connectivity than sham group. The MIP was significantly different after IMT. Respiratory rate (P = 0.344), inspiratory time (P = 0.222), expiratory time (P = 1.000), and inspiratory time/total breath time (P = 0.572) of respiratory patterns showed no significant change after IMT. All DMN components showed decreased, while insula showed increased activation significantly. DATA CONCLUSION: Differences in brain activity and connectivity may reflect improved ventilatory perception with IMT with a possible role in regulating breathing pattern by processing interoceptive signals. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 4.
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Vardar‐Yağlı et al. (2022) conducted an RCT in Healthy (n=26). Inspiratory muscle training (IMT) vs. Sham IMT (15% of MIP) was evaluated on Insula and default mode network (DMN) connectivity. Inspiratory muscle training significantly decreased default mode network activation and increased insula activation compared to sham, with no significant change in respiratory rate (P=0.344).
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