The load of dyspnoea on brain and legs

Impact of trigeminal nerve and/or olfactory nerve stimulation on activity of human brain regions involved in the perception of breathlessness

“…&Dahme, 2005;von Leupoldt & Farre, 2020;von Leupoldt et al, 2008;von Leupoldt et al, 2009), most notably and consistently the insular cortex(Banzett et al, 2000;Brannan et al, 2001;Esser et al, 2017;Evans et al, 2002;Herigstad et al, 2011;Marlow et al, 2019;Peiffer et al, 2001;Stoeckel et al, 2016;von Leupoldt et al, 2008), the anterior cingulate cortex(Brannan et al, 2001;Esser et al, 2017;Evans et al, 2002;Herigstad et al, 2011;Marlow et al, 2019;Stoeckel, Esser, Gamer, Büchel, et al, 2018), and the amygdala(Brannan et al, 2001;Esser et al, 2017;Evans et al, 2002;Herigstad et al, 2011;Marlow et al, 2019;von Leupoldt et al, 2008). The anterior cingulate cortex has also been implicated in the relief of breathlessness following a decrease in external resistive loading(Peiffer, Costes, Hervé, & Garcia-Larrea, 2008) or in response to intravenous opioid administration(Pattinson et al, 2009) in healthy people.…”

The breathing brain: The potential of neural oscillations for the understanding of respiratory perception in health and disease

“…The variety of human natural frequencies that can be captured using (intracranial) EEG or MEG allow for insight into spectral dynamics from the level of neuronal clusters up to the long‐distance communication between distinct cortical and subcortical structures (Jerath et al., 2019). Given that dyspnea comprises multiple qualitatively distinct aspects, from sensory aspects such as increased effort sensation to air hunger and chest tightness/pain (Laviolette & Laveneziana, 2014), to affective changes such as increased fear and anxiety (Janssens et al., 2011; von Leupoldt & Denutte, 2020), and finally changes in cognitive, executive, and motor functioning (von Leupoldt & Farre, 2020; Sucec et al., 2018), such variety may be important in delineating the underlying neural mechanisms of this complex symptom. In particular, drawing on the theoretical concepts and designs from cognitive neuroscience could prove helpful in directing the future research into central mechanisms of dyspnea.…”

“…Many respiratory diseases, for example, COPD and obstructive sleep apnea, present with moderate cognitive impairments which cannot be fully explained by the advanced age of the patients (van Beers et al., 2018; Dodd et al., 2010; von Leupoldt & Farre, 2020; Vaessen et al., 2015). It has been suggested that the cognitive decline is at least partly a result of intermittent sustained hypoxemia due to the occluded airways (Lal et al., 2012; Thakur et al., 2010), an interpretation supported by the findings of significantly altered brain networks and brain structure.…”

“…Moreover, the coupling of (hippocampal) theta rhythm with the fast gamma oscillations is thought to underlie memory consolidation, and has been found to be increased in mice during REM sleep (Scheffzük et al., 2011). Uncoupling of these oscillations during acute or chronic dyspnea might underlie the observed detrimental effects of dyspnea on cognitive executive functioning (von Leupoldt & Farre, 2020), which awaits experimental testing in individuals with and without chronic dyspnea. We have already discussed the recent developments in neuroscience showing that respiratory rhythm may modulate high‐frequency gamma oscillations (Ito et al., 2014; Kluger & Gross, 2020), which have been associated with memory encoding (Herrmann et al., 2010).…”

Impact of cognitive capacity on physical performance in chronic obstructive pulmonary disease patients: A scoping review

“…Indeed, dyspnea is not only a physical symptom but also an interoceptive stimuli that requires cortical and subcortical processing. 23 , 24 In COPD, hypoxemia may lead to cognitive dysfunction through neuronal injury. 25 The aim of this scoping review was to investigate the relationship between cognitive function and motor control in COPD patients, and whether treatments improve cognitive and physical function.…”