Neuroimaging of central breathlessness mechanisms

Abstract

Neuroimaging of breathlessness remains in its infancy. However, advances in the understanding of central perception, combined with novel neuroimaging techniques, means that we are poised to increase our understanding of the brain processes of breathlessness and their modulation.

What's trending in breathlessness research? Proceedings from the 8th Annual Meeting of the Breathlessness Research Interest Group

“…Understanding the neural pathways involved will improve our understanding of breathlessness and therapies could potentially be targeted to these central mechanisms. 4 The periaqueductal gray (PAG) is a small structure located superiorly in the brainstem and as it sits at a junction between the cortex and brainstem, is key in the emotional and mechanical control of breathing. We know from animal models that the PAG is involved in active and passive coping strategies and through connectivity to other parts of the brain, its activity can be up-or down-regulated in response to different situations such as pain or breath-holding.…”

“…Although much has been elucidated with the advent of positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), most studies have been on healthy volunteers using models of induced acute breathlessness. 4 Magnetoencephalography (MEG) scanning is a form of functional brain imaging which detects changes in magnetic fields generated by the electrical currents caused by neuronal activity. It therefore differs from fMRI where changes in brain activity are inferred from measured changes in blood flow due to altered metabolic activity.…”

The mechanisms of breathlessness in heart failure as the basis of therapy

“…intensity, unpleasantness); intensity of breathlessness is increased with mismatch between respiratory neural drive and afferent feedback from the respiratory system. Most research, including functional neuroimaging to delineate central breathlessness perception pathways [4,5], has been conducted in people with respiratory disease. However, aspects have been investigated in CHF, in particular, the role of skeletal muscle and the sympathetic autonomic nervous system (SNS) which is summarized to set the context for recent work regarding targeted therapies.…”

The brain and breathlessness: Understanding and disseminating a palliative care approach

“…2,3 It has been firmly established that breathlessness is a complex experience of the mind and the body, comprising different sensations that can only be perceived by the individual. Affective components drive the accompanying feelings of distress, fear and anxiety, and it is the brain, not the lungs, that generates these phenomena.…”