title: Functional connectivity and information flow of the respiratory neural network in chronic obstructive pulmonary disease.
abstract: Breathing involves a complex interplay between the brainstem automatic network and cortical voluntary command. How these brain regions communicate at rest or during inspiratory loading is unknown. This issue is crucial for several reasons: (i) increased respiratory loading is a major feature of several respiratory diseases, (ii) failure of the voluntary motor and cortical sensory processing drives is among the mechanisms that precede acute respiratory failure, (iii) several cerebral structures involved in responding to inspiratory loading participate in the perception of dyspnea, a distressing symptom in many disease. We studied functional connectivity and Granger causality of the respiratory network in controls and patients with chronic obstructive pulmonary disease (COPD), at rest and during inspiratory loading. Compared with those of controls, the motor cortex area of patients exhibited decreased connectivity with their contralateral counterparts and no connectivity with the brainstem. In the patients, the information flow was reversed at rest with the source of the network shifted from the medulla towards the motor cortex. During inspiratory loading, the system was overwhelmed and the motor cortex became the sink of the network. This major finding may help to understand why some patients with COPD are prone to acute respiratory failure. Network connectivity and causality were related to lung function and illness severity. We validated our connectivity and causality results with a mathematical model of neural network. Our findings suggest a new therapeutic strategy involving the modulation of brain activity to increase motor cortex functional connectivity and improve respiratory muscles performance in patients. Hum Brain Mapp 37:2736-2754, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
authors.affiliation: Department of Physics, Matter and Complex Systems Research Laboratory, UMR 7057, CNRS, Paris 7 University, France.|Institute of Theoretical Physics, Lanzhou University, Lanzhou, China.
authors.forename: Lianchun
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Physics, Matter and Complex Systems Research Laboratory, UMR 7057, CNRS, Paris 7 University, France.|Ecole Normale Supérieure, Paris, France.
authors.forename: Marine
authors.initials: M
authors.lastname: De Mazancourt
authors.affiliation: Neuroradiology Department, APHP, Hôpital Bichat, France.
authors.forename: Agathe
authors.initials: A
authors.lastname: Hess
authors.affiliation: Department of Physics, Matter and Complex Systems Research Laboratory, UMR 7057, CNRS, Paris 7 University, France.
authors.forename: Fakhrul R
authors.initials: FR
authors.lastname: Ashadi
authors.affiliation: Neuroradiology Department, APHP, Hôpital Bichat, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Klein
authors.affiliation: Respiratory Disease Department, APHP, Hôpital Bichat, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Mal
authors.affiliation: Department of Physics, Matter and Complex Systems Research Laboratory, UMR 7057, CNRS, Paris 7 University, France.
authors.forename: Maurice
authors.initials: M
authors.lastname: Courbage
authors.affiliation: Department of Physics, Matter and Complex Systems Research Laboratory, UMR 7057, CNRS, Paris 7 University, France.|Department of Physiology, APHP, Hôpital Bichat, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Mangin
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D009415:Nerve Net / Q000503:physiopathology*; D009434:Neural Pathways / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012119:Respiration
keywords: Granger causality; brain; breathing; functional connectivity; neural network