title: A bilateral cortico-bulbar network associated with breath holding in humans, determined by functional magnetic resonance imaging.
abstract: Few tasks are simpler to perform than a breath hold; however, the neural basis underlying this voluntary inhibitory behaviour, which must suppress spontaneous respiratory motor output, is unknown. Here, using blood oxygen level-dependent functional magnetic resonance imaging (BOLD fMRI), we investigated the neural network responsible for volitional breath holding in 8 healthy humans. BOLD images of the whole brain (156 brain volumes, voxel resolution 3x3x3 mm) were acquired every 5.2 s. All breath holds were performed for 15 s at resting expiratory lung volume when respiratory musculature was presumed to be relaxed, which ensured that the protocol highlighted the inhibitory components underlying the breath hold. An experimental paradigm was designed to dissociate the time course of the whole-brain BOLD signal from the time course of the local, neural-related BOLD signal associated with the inhibitory task. We identified a bilateral network of cortical and subcortical structures including the insula, basal ganglia, frontal cortex, parietal cortex and thalamus, which are in common with response inhibition tasks, and in addition, activity within the pons. From these results we speculate that the pons has a role in integrating information from supra-brainstem structures, and in turn it exerts an inhibitory effect on medullary respiratory neurones to inhibit breathing during breath holding.
authors.affiliation: Department of Respiratory Medicine, National Heart and Lung Institute, Imperial College School of Medicine, London, UK.
authors.forename: Leanne C
authors.initials: LC
authors.lastname: McKay
authors.forename: Lewis
authors.initials: L
authors.lastname: Adams
authors.forename: Richard S J
authors.initials: RS
authors.lastname: Frackowiak
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Corfield
mesh_terms: D000328:Adult; D001784:Blood Gas Analysis; D001923:Brain Chemistry / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D003627:Data Interpretation, Statistical; D004576:Electromyography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D011650:Pulmonary Alveoli / Q000378:metabolism; D011712:Pyramidal Tracts / Q000502:physiology*; D015656:Respiratory Mechanics / Q000502:physiology*; D012132:Respiratory Muscles / Q000502:physiology
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen