“…ENS patients at rest had been presented with temporal and cerebellar activation similar to experiments involving respiratory distress and air hunger during CO 2 inhalation, respectively . This abnormal signaling to the brain may produce the constant feeling of respiratory distress in ENS patients, leading to functional impairment such as distraction, chronic fatigue, frustration, irritability, depression, and anxiety . Thus, it is reasonable that improvement in “dyspnea sensation” after surgical intervention would change not only anatomical figures but the abnormal brain signals, resulting in improvement in mental status.…”