A bilateral cortico-bulbar network associated with breath holding in humans, determined by functional magnetic resonance imaging

McKay, Leanne C.; Adams, Lewis; Frackowiak, R. S. J.; Corfield, Douglas R.

doi:10.1016/j.neuroimage.2008.01.058

Cited by 104 publications

(119 citation statements)

References 55 publications

Supporting

Mentioning

107

Contrasting

Order By: Relevance

“…8) areas strongly connected to each other (Kelly and Strick, 2003) and implicated in dyspnea relief . Activity in the DLPFC has been associated with response inhibition (Watanabe et al, 2002) including breath holding (McKay et al, 2008).…”

Section: Opioid-sensitive Aspects Of the Breath Holdmentioning

confidence: 99%

“…The subthalamic nuclei have previously been implicated in mediating inhibitory actions (Aron and Poldrack, 2006;McKay et al, 2008). Reduced activations in these nuclei imply that, with remifentanil, less cortical inhibition is necessary to stop breathing, which is already depressed at a brainstem level.…”

Section: Opioid-sensitive Aspects Of the Breath Holdmentioning

confidence: 99%

“…The ventrolateral medulla has been identified as a crucial center for automatic breathing (Feldman and Del Negro, 2006), but whether activity there is modulated by conscious mechanisms remains unexplained (Corfield et al, 1998;McKay et al, 2003McKay et al, , 2008.…”

Section: Brainstemmentioning

confidence: 99%

“…In vivo evaluation of drug effects on breathing is usually achieved by measuring depression of hypoxic and hypercapnic ventilatory responses (Bailey et al, 2000;Dahan and Teppema, 2003;Mitsis et al, 2009). These measurements give reliable estimation of drug-induced changes in chemoreflex responsiveness; however, brainstem respiratory control mechanisms are also modulated by inputs from higher centers in the cortex (Colebatch et al, 1991;Corfield et al, 1998;McKay et al, 2003McKay et al, , 2008. Although it is well established that opioids depress the brainstem respiratory control centers (Pattinson, 2008), in patients receiving opioids, pain and arousal state are particularly critical in determining the final respiratory output, suggesting that conscious mechanisms are also important.…”

Section: Introductionmentioning

confidence: 99%

“…Such studies suggest that the insula and operculum mediate dyspnea (Banzett et al, 2000;Evans et al, 2002;McKay et al, 2008;Peiffer, 2008;Peiffer et al, 2008;von Leupoldt et al, 2008), and the cingulate gyrus, the prefrontal cortex, and the supramarginal gyrus integrate emotional and sensory aspects of respiration. The motor cortex is implicated in the volitional control of breathing and speech (Gandevia and Rothwell, 1987;McKay et al, 2003;Brown et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Opioids Depress Cortical Centers Responsible for the Volitional Control of Respiration

Pattinson¹,

Governo²,

MacIntosh³

et al. 2009

Journal of Neuroscience

156

138

View full text Add to dashboard Cite

Respiratory depression limits provision of safe opioid analgesia and is the main cause of death in drug addicts. Although opioids are known to inhibit brainstem respiratory activity, their effects on cortical areas that mediate respiration are less well understood. Here, functional magnetic resonance imaging was used to examine how brainstem and cortical activity related to a short breath hold is modulated by the opioid remifentanil. We hypothesized that remifentanil would differentially depress brain areas that mediate sensoryaffective components of respiration over those that mediate volitional motor control. Quantitative measures of cerebral blood flow were used to control for hypercapnia-induced changes in blood oxygen level-dependent (BOLD) signal. Awareness of respiration, reflected by an urge-to-breathe score, was profoundly reduced with remifentanil. Urge to breathe was associated with activity in the bilateral insula, frontal operculum, and secondary somatosensory cortex. Localized remifentanil-induced decreases in breath hold-related activity were observed in the left anterior insula and operculum. We also observed remifentanil-induced decreases in the BOLD response to breath holding in the left dorsolateral prefrontal cortex, anterior cingulate, the cerebellum, and periaqueductal gray, brain areas that mediate task performance. Activity in areas mediating motor control (putamen, motor cortex) and sensory-motor integration (supramarginal gyrus) were unaffected by remifentanil. Breath hold-related activity was observed in the medulla. These findings highlight the importance of higher cortical centers in providing contextual awareness of respiration that leads to appropriate modulation of respiratory control. Opioids have profound effects on the cortical centers that control breathing, which potentiates their actions in the brainstem.

show abstract

Section: Opioid-sensitive Aspects Of the Breath Holdmentioning

confidence: 99%

Section: Opioid-sensitive Aspects Of the Breath Holdmentioning

confidence: 99%

Section: Brainstemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Opioids Depress Cortical Centers Responsible for the Volitional Control of Respiration

Pattinson¹,

Governo²,

MacIntosh³

et al. 2009

Journal of Neuroscience

156

138

View full text Add to dashboard Cite

show abstract

Ictal Central Apnea Is Predictive of Mesial Temporal Seizure Onset: An Intracranial Investigation

Lacuey,

Talavera,

Magana‐Tellez

et al. 2024

Annals of Neurology

View full text Add to dashboard Cite

ObjectiveIctal central apnea (ICA) is a semiological sign of focal epilepsy, associated with temporal and frontal lobe seizures. In this study, using qualitative and quantitative approaches, we aimed to assess the localizational value of ICA. We also aimed to compare ICA clinical utility in relation to other seizure semiological features of focal epilepsy.MethodsWe analyzed seizures in patients with medically refractory focal epilepsy undergoing intracranial stereotactic electroencephalographic (SEEG) evaluations with simultaneous multimodal cardiorespiratory monitoring. A total of 179 seizures in 72 patients with reliable artifact‐free respiratory signal were analyzed.ResultsICA was seen in 55 of 179 (30.7%) seizures. Presence of ICA predicted a mesial temporal seizure onset compared to those without ICA (odds ratio = 3.8, 95% confidence interval = 1.3–11.6, p = 0.01). ICA specificity was 0.82. ICA onset was correlated with increased high‐frequency broadband gamma (60–150Hz) activity in specific mesial or basal temporal regions, including amygdala, hippocampus, and fusiform and lingual gyri. Based on our results, ICA has an almost 4‐fold greater association with mesial temporal seizure onset zones compared to those without ICA and is highly specific for mesial temporal seizure onset zones. As evidence of symptomatogenic areas, onset‐synchronous increase in high gamma activity in mesial or basal temporal structures was seen in early onset ICA, likely representing anatomical substrates for ICA generation.InterpretationICA recognition may help anatomoelectroclinical localization of clinical seizure onset to specific mesial and basal temporal brain regions, and the inclusion of these regions in SEEG evaluations may help accurately pinpoint seizure onset zones for resection. ANN NEUROL 2024

show abstract

An improved method for acquiring cerebrovascular reactivity maps

et al. 2010

View full text Add to dashboard Cite

This study aims to improve the method used to produce cerebrovascular reactivity (CVR) maps by MRI. Previous methods have used a standard boxcar presentation of carbon dioxide (CO 2 ). Here this is replaced with a sinusoidally modulated CO 2 stimulus. This allowed the use of Fourier analysis techniques to measure both the amplitude and phase delay of the BOLD CVR response, and hence characterize the arrival sequence of blood to different regions of the brain. This characterization revealed statistically significant relative delays between regions of the brain (ANOVA < 0.0001). In addition, post hoc comparison showed that the frontal (P < 0.001) and parietal (P 5 0.004) lobes reacted earlier than the occipital lobe. Cerebrovascular reactivity (CVR) mapping using MRI is increasingly used to assess the effects of cerebrovascular conditions such as atherosclerotic steno-occlusive disease (1,2) and Moyamoya (3). CVR is conventionally mapped by administering CO 2 mixed with air through an open oxygen face mask. In early measurements, this stimulus was applied in an interleaved fashion with blocks of air, while BOLD-weighted images and measurements of end-tidal PCO 2 (PETCO 2 ) are acquired (4,5). This PETCO 2 time-course is then regressed against the BOLD data on a pixel-by-pixel basis to create CVR maps showing the strength of the correlation (2,6). The underlying assumption in generating maps in this way is that the CVR response occurs in all parts of the brain simultaneously. However, if the change in PCO 2 carried by the blood arrived in various areas of the brain at different times, or if there were a delayed vascular response to this change in PCO 2 in some brain regions, then the correlation between the BOLD signal and the PETCO 2 , and thus CVR, could be underestimated. Furthermore, variations in the arrival time of blood or response time of the vasculature, in different areas of the brain may provide useful diagnostic information.The aim of this study is to improve upon the existing BOLD CVR methodology by acquiring potentially useful information about the regional delays in the BOLD CVR response while minimizing errors due to any regional delays. This is achieved by combining a sinusoidally varying carbon dioxide stimulus with Fourier analysis techniques. To apply an accurate sinusoidal stimulus, a computerized gas blender was used along with a modelbased algorithm for prospective targeting and control of end-tidal PO 2 (PETO 2 ) and PCO 2 (7). This algorithm allows more accurate and independent control of PETO 2 and PETCO 2 than that achieved by simply presenting CO 2 mixed with air. This enables arbitrarily shaped changes in PETCO 2 to be administered, such as the sinusoid used here. This stimulus delivery can then be coupled with Fourier analysis techniques, as used in retinotopic mapping (8). This analysis method was chosen as synchronization of the MRI, and PETCO 2 data is not required, as it is the frequency of the signal that is detected, reducing confounding effects of inaccurate synchronization. In ...

show abstract

A bilateral cortico-bulbar network associated with breath holding in humans, determined by functional magnetic resonance imaging

Cited by 104 publications

References 55 publications

Opioids Depress Cortical Centers Responsible for the Volitional Control of Respiration

Opioids Depress Cortical Centers Responsible for the Volitional Control of Respiration

Ictal Central Apnea Is Predictive of Mesial Temporal Seizure Onset: An Intracranial Investigation

An improved method for acquiring cerebrovascular reactivity maps

Contact Info

Product

Resources

About