Key result
Patients with COPD exhibited decreased motor cortex connectivity with contralateral counterparts and the brainstem compared to controls, with reversed information flow at rest.
Why the study?
How does functional connectivity and information flow of the respiratory neural network differ between COPD patients and controls at rest and during inspiratory loading?
Observational
How does functional connectivity and information flow of the respiratory neural network differ between COPD patients and controls at rest and during inspiratory loading?
COPD patients exhibit altered functional connectivity and reversed information flow in the respiratory neural network, which may explain their susceptibility to acute respiratory failure.
May indicate neural reorganization in COPD; leaves open links to symptoms and need for prospective studies.
Breathing involves a complex interplay between the brainstem automatic network and cortical voluntary command. How these brain regions communicate at rest or during inspiratory loading is unknown. This issue is crucial for several reasons: (i) increased respiratory loading is a major feature of several respiratory diseases, (ii) failure of the voluntary motor and cortical sensory processing drives is among the mechanisms that precede acute respiratory failure, (iii) several cerebral structures involved in responding to inspiratory loading participate in the perception of dyspnea, a distressing symptom in many disease. We studied functional connectivity and Granger causality of the respiratory network in controls and patients with chronic obstructive pulmonary disease (COPD), at rest and during inspiratory loading. Compared with those of controls, the motor cortex area of patients exhibited decreased connectivity with their contralateral counterparts and no connectivity with the brainstem. In the patients, the information flow was reversed at rest with the source of the network shifted from the medulla towards the motor cortex. During inspiratory loading, the system was overwhelmed and the motor cortex became the sink of the network. This major finding may help to understand why some patients with COPD are prone to acute respiratory failure. Network connectivity and causality were related to lung function and illness severity. We validated our connectivity and causality results with a mathematical model of neural network. Our findings suggest a new therapeutic strategy involving the modulation of brain activity to increase motor cortex functional connectivity and improve respiratory muscles performance in patients. Hum Brain Mapp 37:2736-2754, 2016.
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Yu et al. (2016) conducted an observational in Chronic obstructive pulmonary disease (COPD). Chronic obstructive pulmonary disease vs. Controls was evaluated on Functional connectivity and Granger causality of the respiratory network at rest and during inspiratory loading. Patients with COPD exhibited decreased motor cortex connectivity with contralateral counterparts and the brainstem compared to controls, with reversed information flow at rest.
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