scholarly journals Brain activity measured by functional brain imaging predicts breathlessness improvement during pulmonary rehabilitation

Author(s):  
Sarah Louise Finnegan ◽  
Michael Browning ◽  
Eugene Duff ◽  
Catherine J. Harmer ◽  
Andrea Reinecke ◽  
...  

Background: Chronic breathlessness in COPD is effectively treated with pulmonary rehabilitation. However, baseline patient characteristics predicting improvements in breathlessness are unknown. This knowledge may provide better understanding of the mechanisms engaged in treating breathlessness, helping to individualise therapy. Increasing evidence supports the role of expectation (i.e. placebo and nocebo effects) in breathlessness perception. In this study, we tested functional brain imaging markers of breathlessness expectation as predictors of therapeutic response to pulmonary rehabilitation, and whether D-cycloserine, a brain-active drug known to influence expectation mechanisms, modulates any predictive model. Methods: Data from 72 participants with mild-to-moderate COPD recruited to a randomised double-blind controlled experimental medicine study of D-cycloserine given during pulmonary rehabilitation was analysed (ID: NCT01985750). Baseline variables, including brain-activity, self-report questionnaires responses, clinical measures of respiratory function and drug allocation were used to train machine-learning models to predict the outcome, a minimally clinically relevant change in the dyspnoea-12 score. Findings: Only models that included brain imaging markers of breathlessness-expectation successfully predicted improvements in dyspnoea-12 score (sensitivity 0.88, specificity 0.77). D-cycloserine was independently associated with breathlessness improvement. Models that included only questionnaires and clinical measures did not predict outcome (sensitivity 0.68, specificity 0.2). Interpretation: Brain activity to breathlessness related cues is a strong predictor of clinical improvement in breathlessness over pulmonary rehabilitation. This implies that expectation is key in breathlessness perception. Manipulation of the brain's expectation pathways (either pharmacological or non-pharmacological) merits further testing in the treatment of chronic breathlessness.

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Christian Weisstanner ◽  
Manuela Wapp ◽  
Martin Schmitt ◽  
Stefan Puig ◽  
Livio Mordasini ◽  
...  

2017 ◽  
Vol 16 (3) ◽  
pp. e1934-e1935
Author(s):  
C. Weisstanner ◽  
M. Wapp ◽  
M. Schmitt ◽  
S. Puig ◽  
L. Mordasini ◽  
...  

2001 ◽  
Vol 24 (3) ◽  
pp. 189-203 ◽  
Author(s):  
Todd L. Richards

This tutorial/review covers functional brain-imaging methods and results used to study language and reading disabilities. Although the main focus is on functional MRI and functional MR spectroscopy, other imaging techniques are discussed briefly such as positron emission tomography (PET), electroencephalography (EEG), magnetoencepholography (MEG), and MR diffusion imaging. These functional brain-imaging studies have demonstrated that dyslexia is a brain-based disorder and that serial imaging studies can be used to study the effect of treatment on functional brain activity.


Neuron ◽  
2014 ◽  
Vol 81 (5) ◽  
pp. 1203-1213 ◽  
Author(s):  
Angela Heck ◽  
Matthias Fastenrath ◽  
Sandra Ackermann ◽  
Bianca Auschra ◽  
Horst Bickel ◽  
...  

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Takamasa Ando ◽  
Tatsuya Nakamura ◽  
Toshiya Fujii ◽  
Teruhiro Shiono ◽  
Tasuku Nakamura ◽  
...  

AbstractA revolution in functional brain imaging techniques is in progress in the field of neurosciences. Optical imaging techniques, such as high-density diffuse optical tomography (HD-DOT), in which source-detector pairs of probes are placed on subjects’ heads, provide better portability than conventional functional magnetic resonance imaging (fMRI) equipment. However, these techniques remain costly and can only acquire images at up to a few measurements per square centimetre, even when multiple detector probes are employed. In this study, we demonstrate functional brain imaging using a compact and affordable setup that employs nanosecond-order pulsed ordinary laser diodes and a time-extracted image sensor with superimposition capture of scattered components. Our technique can simply and easily attain a high density of measurement points without requiring probes to be attached, and can directly capture two-dimensional functional brain images. We have demonstrated brain activity imaging using a phantom that mimics the optical properties of an adult human head, and with a human subject, have measured cognitive brain activation while the subject is solving simple arithmetical tasks.


2021 ◽  
Author(s):  
Sarah Louise Finnegan ◽  
Olivia K Harrison ◽  
Sara Booth ◽  
Andrea Dennis ◽  
Martyn Ezra ◽  
...  

Rationale: For people with Chronic Obstructive Pulmonary Disease (COPD), improvements in breathlessness from pulmonary rehabilitation are neither long lasting nor guaranteed. Previously, we showed that pulmonary rehabilitation induced brain activity changes akin to those seen in exposure based cognitive behavioural therapies (CBT) in other conditions. D-cycloserine is a partial NMDA-receptor agonist which has been shown to enhance CBT. Objectives: Here, we tested whether D-cycloserine would augment the effects of pulmonary rehabilitation on activity in brain areas that process breathlessness expectation. Methods: 72 participants with mild-to-moderate COPD were recruited to a double-blind experimental medicine study running parallel to a pulmonary rehabilitation course. Participants were randomised to 250mg D-cycloserine or matched placebo, administered 15-30 minutes prior to the first four sessions of pulmonary rehabilitation. Brain functional magnetic resonance imaging, self-report questionnaires and clinical measures of respiratory function were collected at three time points: before, during (2-3 weeks) and after pulmonary rehabilitation (6-8 weeks). Measurements: Primary and secondary outcome measures were difference in mean and voxel-wise brain activity across key brain regions of interest. An exploratory analysis determined the interaction with breathlessness-anxiety. Main results: No difference was observed in either primary or secondary outcome measures. However, in the exploratory analysis, D-cycloserine attenuated the relationship between brain activity and breathlessness-anxiety within prefrontal cortex, superior frontal gyrus and precuneus. Conclusions: The observed effects suggest that D-cycloserine augments pulmonary rehabilitation by dampening reactivity to breathlessness cues in brain areas associated with breathlessness expectation and anxiety. This work highlights the opportunity to test brain-active drugs in the context of augmenting behavioural interventions.


2021 ◽  
Vol 12 ◽  
Author(s):  
Mohammed Bermo ◽  
Mohammed Saqr ◽  
Hunter Hoffman ◽  
David Patterson ◽  
Sam Sharar ◽  
...  

Functional neuroimaging modalities vary in spatial and temporal resolution. One major limitation of most functional neuroimaging modalities is that only neural activation taking place inside the scanner can be imaged. This limitation makes functional neuroimaging in many clinical scenarios extremely difficult or impossible. The most commonly used radiopharmaceutical in Single Photon Emission Tomography (SPECT) functional brain imaging is Technetium 99 m-labeled Ethyl Cysteinate Dimer (ECD). ECD is a lipophilic compound with unique pharmacodynamics. It crosses the blood brain barrier and has high first pass extraction by the neurons proportional to regional brain perfusion at the time of injection. It reaches peak activity in the brain 1 min after injection and is then slowly cleared from the brain following a biexponential mode. This allows for a practical imaging window of 1 or 2 h after injection. In other words, it freezes a snapshot of brain perfusion at the time of injection that is kept and can be imaged later. This unique feature allows for designing functional brain imaging studies that do not require the patient to be inside the scanner at the time of brain activation. Functional brain imaging during severe burn wound care is an example that has been extensively studied using this technique. Not only does SPECT allow for imaging of brain activity under extreme pain conditions in clinical settings, but it also allows for imaging of brain activity modulation in response to analgesic maneuvers whether pharmacologic or non-traditional such as using virtual reality analgesia. Together with its utility in extreme situations, SPECTS is also helpful in investigating brain activation under typical pain conditions such as experimental controlled pain and chronic pain syndromes.


2016 ◽  
Vol 39 ◽  
Author(s):  
Martin Desseilles ◽  
Christophe Phillips

AbstractIn this commentary on Firestone & Scholl's (F&S's) article, we argue that researchers should use brain-activity modelling to investigate top-down mechanisms. Using functional brain imaging and a specific cognitive paradigm, modelling the BOLD signal provided new insight into the dynamic causalities involved in the influence of cognitions on perceptions.


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