title: Structural brain changes related to disease duration in patients with asthma.
abstract: Dyspnea is the impairing, cardinal symptom patients with asthma repeatedly experience over the course of the disease. However, its accurate perception is also crucial for timely initiation of treatment. Reduced perception of dyspnea is associated with negative treatment outcome, but the underlying brain mechanisms of perceived dyspnea in patients with asthma remain poorly understood. We examined whether increasing disease duration in fourteen patients with mild-to-moderate asthma is related to structural brain changes in the insular cortex and brainstem periaqueductal grey (PAG). In addition, the association between structural brain changes and perceived dyspnea were studied. By using magnetic resonance imaging in combination with voxel-based morphometry, gray matter volumes of the insular cortex and the PAG were analysed and correlated with asthma duration and perceived affective unpleasantness of resistive load induced dyspnea. Whereas no associations were observed for the insular cortex, longer duration of asthma was associated with increased gray matter volume in the PAG. Moreover, increased PAG gray matter volume was related to reduced ratings of dyspnea unpleasantness. Our results demonstrate that increasing disease duration is associated with increased gray matter volume in the brainstem PAG in patients with mild-to-moderate asthma. This structural brain change might contribute to the reduced perception of dyspnea in some patients with asthma and negatively impact the treatment outcome.
authors: Department of Psychology, University of Hamburg, Hamburg, Germany. andreas.vonleupoldt@uni-hamburg.de
authors: Andreas
authors: A
authors: von Leupoldt
authors: Stefanie
authors: S
authors: Brassen
authors: Hans Jörg
authors: HJ
authors: Baumann
authors: Hans
authors: H
authors: Klose
authors: Christian
authors: C
authors: Büchel
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications* / Q000473:pathology; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000209:etiology; D016022:Case-Control Studies; D002540:Cerebral Cortex; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D059906:Neuroimaging; D010487:Periaqueductal Gray; D013997:Time Factors; D055815:Young Adult