Breath hold task induces temporal heterogeneity in electroencephalographic regional field power in healthy subjects

2020 ◽  
Author(s):  
Maria Sole Morelli ◽  
Nicola Vanello ◽  
Alejandro Luis Callara ◽  
Valentina Hartwig ◽  
Michelangelo Maestri ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Free Breathing ◽  
Time Shift ◽  
Breath Hold ◽  
Global Field Power ◽  
Cross Correlation Analysis ◽  
Ascending Pathways ◽  
Positive Time ◽  
End Tidal ◽  
Α Band

While the brainstem is in charge of the automatic control of ventilation, the cortex is involved in the voluntary control of breathing but also receives inputs from the brainstem, which influence the perception of breathing and the arousal state and sleep architecture in conditions of hypoxia/hypercapnia. We evaluated in eleven healthy subjects the effects of breath hold (BH: 30 seconds of apneas and 30 seconds of normal breathing) and BH-related CO2/O2 changes on electroencephalogram (EEG) global field power (GFP) and regional field power (RFP) in 9 different areas (3 rostrocaudal sections -anterior, central, posterior- and 3 sagittal sections -left, middle, right) in the δ and α bands, by cross correlation analysis. No significant differences were observed in GFP and RFP when comparing free breathing (FB) with the BH task. Within the BH task, the shift from apnea to normal ventilation was accompanied by an increase in the δ power and a decrease in the α power. The end-tidal pressure of CO2 (PETCO2) was positively correlated with the δ-band and negatively with the α- band with a positive time shift, while an opposite behaviour was found for the end-tidal pressure of O2 (PETO2). Notably, the time shift between PETCO2/PETO2 signals and cortical activity at RFP was heterogenous and seems to follow a hierarchical activation with the δ-band responding earlier than the α band. Overall, these findings suggest that the effect of BH on the cortex may follow specific ascending pathways from the brainstem and be related to chemoreflex stimulation.

scholarly journals Radial-based acquisition strategies for pre-procedural non-contrast cardiovascular magnetic resonance angiography of the pulmonary veins

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Pascale Aouad ◽  
Ioannis Koktzoglou ◽  
Bastien Milani ◽  
Ali Serhal ◽  
Jose Nazari ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Image Quality ◽  
Healthy Subjects ◽  
Respiratory Gating ◽  
Free Breathing ◽  
Breath Hold ◽  
Thin Slab ◽  
Excellent Correlation ◽  
Acquisition Strategies ◽  
Stack Of Stars

Abstract Background Computed tomography angiography (CTA) or contrast-enhanced (CE) cardiovascular magnetic resonance angiography (CMRA) is often obtained in patients with atrial fibrillation undergoing evaluation prior to pulmonary vein (PV) isolation. Drawbacks of CTA include radiation exposure and potential risks from iodinated contrast agent administration. Free-breathing 3D balanced steady-state free precession (bSSFP) Non-contrast CMRA is a potential imaging option, but vascular detail can be suboptimal due to ghost artifacts and blurring that tend to occur with a Cartesian k-space trajectory or, in some cases, inconsistent respiratory gating. We therefore explored the potential utility of both breath-holding and free-breathing non-contrast CMRA, using radial k-space trajectories that are known to be less sensitive to flow and motion artifacts than Cartesian. Main body Free-breathing 3D Cartesian and radial stack-of-stars acquisitions were compared in 6 healthy subjects. In addition, 27 patients underwent CTA and non-contrast CMRA for PV mapping. Three radial CMR acquisition strategies were tested: (1) breath-hold (BH) 2D radial bSSFP (BH-2D); (2) breath-hold, multiple thin-slab 3D stack-of-stars bSSFP (BH-SOS); and (3) navigator-gated free-breathing (FB) 3D stack-of-star bSSFP using a spatially non-selective RF excitation (FB-NS-SOS). A non-rigid registration algorithm was used to compensate for variations in breath-hold depth. In healthy subjects, image quality and vessel sharpness using a free-breathing 3D SOS acquisition was significantly better than free-breathing (FB) Cartesian 3D. In patients, diagnostic image quality was obtained using all three radial CMRA techniques, with BH-SOS and FB-NS-SOS outperforming BH-2D. There was overall good correlation for PV maximal diameter between BH-2D and CTA (ICC = 0.87/0.83 for the two readers), excellent correlation between BH-SOS and CTA (ICC = 0.90/0.91), and good to excellent correlation between FB-NS-SOS and CTA (ICC = 0.87/0.94). For PV area, there was overall good correlation between BH-2D and CTA (ICC = 0.79/0.83), good to excellent correlation between BH-SOS and CTA (ICC = 0.88/0.91) and excellent correlation between FB-NS-SOS and CTA (ICC = 0.90/0.95). CNR was significantly higher with BH-SOS (mean = 11.04) by comparison to BH-2D (mean = 6.02; P = 0.007) and FB-NS-SOS (mean = 5.29; P = 0.002). Conclusion Our results suggest that a free-breathing stack-of-stars bSSFP technique is advantageous in providing accurate depiction of PV anatomy and ostial measurements without significant degradation from off-resonance artifacts, and with better image quality than Cartesian 3D. For patients in whom respiratory gating is unsuccessful, a breath-hold thin-slab stack-of-stars technique with retrospective motion correction may be a useful alternative.

scholarly journals Point Shear Wave Elastography and the Effect of Physical Exercise, Alcohol Consumption, and Respiration in Healthy Adults

2020 ◽  
Vol 06 (03) ◽  
pp. E54-E61
Author(s):  
Victoria Taraldsen ◽  
Sunneva Tomasgard ◽  
Margrethe Thune Rudlang ◽  
Odd Helge Gilja ◽  
Mette Vesterhus ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Physical Exercise ◽  
Shear Wave ◽  
Healthy Subjects ◽  
Shear Wave Elastography ◽  
Alcohol Exposure ◽  
Free Breathing ◽  
Healthy Adults ◽  
Breath Hold ◽  
Significant Difference

Abstract Purpose Ultrasound elastography is a noninvasive method for liver stiffness measurement (LSM) with the aim of reflecting approximate liver fibrosis load. Despite minimal evidence, current guidelines recommend 10 min of rest and breath hold prior to measurements and offer no advice concerning recent alcohol consumption, leading to challenges in clinical practice. We aimed to investigate how LSM in healthy adults is influenced by physical exercise, recent alcohol consumption, and respiration. Materials and Methods 42 healthy subjects aged 21–36 years were included. LSM using point shear wave elastography (pSWE) was performed in five stages: baseline, after physical activity, after registration of alcohol consumption, and during breath hold compared to free breathing. Results LSM values were significantly increased following physical exercise compared to baseline values (4.1±0.8 vs. 3.8±0.8 kPa, p=0.01). Alcohol consumption during the last 72 h (0–27 alcohol units) did not significantly affect LSM. There was no significant difference between LSM during breath hold and free breathing. Conclusion In healthy subjects, LSM increased after recent physical exercise, while alcohol consumption 24–72 h prior to examination did not have a significant impact. There was no clinically significant effect of breath hold on LSM. Our study supports present guidelines recommending rest prior to LSM, while indicating that breath hold may not be mandatory. Recent moderate alcohol exposure may affect LSM to a lesser extent than commonly believed.

Comparison of breath-hold and free-breathing quantitative pulmonary perfusion MRI

Pneumologie ◽  
2012 ◽  
Vol 66 (06) ◽  
Author(s):  
D Maxien ◽  
M Ingrisch ◽  
F Meinel ◽  
S Thieme ◽  
MF Reiser ◽  
...  
Keyword(s):  
Free Breathing ◽  
Perfusion Mri ◽  
Breath Hold ◽  
Pulmonary Perfusion

scholarly journals Deep-inspirational breath-hold (DIBH) technique in left-sided breast cancer: various aspects of clinical utility

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Szilvia Gaál ◽  
Zsuzsanna Kahán ◽  
Viktor Paczona ◽  
Renáta Kószó ◽  
Rita Drencsényi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Clinical Utility ◽  
Prospective Trial ◽  
Conformal Radiotherapy ◽  
Free Breathing ◽  
Left Breast ◽  
Breath Hold ◽  
Ipsilateral Lung ◽  
Breast Cancer Radiotherapy

Abstract Background Studying the clinical utility of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and feasibility aspects. Methods In this prospective trial all enrolled patients went through planning CT in supine position under both DIBH and free breathing (FB); in whole breast irradiation (WBI) cases prone CT was also taken. In 3-dimensional conformal radiotherapy (3DCRT) plans heart, left anterior descending coronary artery (LAD), ipsilateral lung and contralateral breast doses were analyzed. The acceptance of DIBH technique as reported by the patients and the staff was analyzed; post-RT side-effects including radiation lung changes (visual scores and lung density measurements) were collected. Results Among 130 enrolled patients 26 were not suitable for the technique while in 16, heart or LAD dose constraints were not met in the DIBH plans. Among 54 and 34 patients receiving WBI and postmastectomy/nodal RT, respectively with DIBH, mean heart dose (MHD) was reduced to < 50%, the heart V25 Gy to < 20%, the LAD mean dose to < 40% and the LAD maximum dose to about 50% as compared to that under FB; the magnitude of benefit was related to the relative increase of the ipsilateral lung volume at DIBH. Nevertheless, heart and LAD dose differences (DIBH vs. FB) individually varied. Among the WBI cases at least one heart/LAD dose parameter was more favorable in the prone or in the supine FB plan in 15 and 4 cases, respectively; differences were numerically small. All DIBH patients completed the RT, inter-fraction repositioning accuracy and radiation side-effects were similar to that of other breast RT techniques. Both the patients and radiographers were satisfied with the technique. Conclusions DIBH is an excellent heart sparing technique in breast RT, but about one-third of the patients do not benefit from that otherwise laborious procedure or benefit less than from an alternative method. Trial registration: retrospectively registered under ISRCTN14360721 (February 12, 2021)

End-tidal pressure of CO2 and exercise performance in healthy subjects

2008 ◽  
Vol 103 (6) ◽  
pp. 727-732 ◽  
Author(s):  
Maurizio Bussotti ◽  
Damiano Magrì ◽  
Emanuele Previtali ◽  
Stefania Farina ◽  
Anna Torri ◽  
...  
Keyword(s):  
Exercise Performance ◽  
Healthy Subjects ◽  
End Tidal

scholarly journals EP-1316: Prone breast radiotherapy in prone: free breathing, deep inspiration breath hold and inspiration gating

2015 ◽  
Vol 115 ◽  
pp. S710
Author(s):  
M. Swimberge ◽  
V. Remouchamps ◽  
L. Veldeman ◽  
T. Mulliez ◽  
B. Speelers ◽  
...  
Keyword(s):  
Free Breathing ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Breast Radiotherapy ◽  
Deep Inspiration Breath Hold

Deep-inspiration breath hold radiotherapy in patients with left-sided breast cancer after partial mastectomy

2021 ◽  
Vol 100 (4) ◽  
Keyword(s):  
Breast Cancer ◽  
Radiation Dose ◽  
Organs At Risk ◽  
Left Lung ◽  
Free Breathing ◽  
Partial Mastectomy ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Dose Volume Histograms

Introduction: The purpose of this study was to compare the radiation dose to organs at risk for deep-inspiration breath hold (DIBH) and free-breathing (FB) radiotherapy in patients with lef-sided breast cancer undergoing adjuvant radiotherapy after partial mastectomy. Methods: One hundred patients with left-sided breast cancer underwent DIBH and FB planning computed tomography scans, and the 2 techniques were compared. Dose-volume histograms were analyzed for heart, left anterior descending coronary artery (LAD), and left lung. Results: Radiation dose to heart, LAD, and left lung was significantly lower for DIBH than for free breathing plans. The median mean heart dose for DIBH technique in comparison with FB was 1.21 Gy, and 3.22 Gy respectively; for LAD, 4.67 versus 24.71 Gy; and for left lung 8.32 Gy versus 9.99 Gy. Conclusion: DIBH is an effective technique to reduce cardiac and lung radiation exposure.

Deep inspiration breath-hold for patients with left-sided breast cancer – A one fits all approach? A prospective analysis of patient selection using dosimetrical and practical aspects

2021 ◽  
pp. 20210295
Author(s):  
Christina Schröder ◽  
Sebastian Kirschke ◽  
Eyck Blank ◽  
Sophia Rohrberg ◽  
Robert Förster ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Left Lung ◽  
Free Breathing ◽  
Lymphatic Drainage ◽  
Breath Hold ◽  
Deep Inspiration ◽  
Deep Inspiration Breath Hold ◽  
Patient Preparation ◽  
Treatment Plans ◽  
Planning Ct

Objective: To prospectively analyze the feasibility of an algorithm for patient preparation, treatment planning and selection for deep inspiration breath-hold (DIBH) treatment of left-sided breast cancer. Methods: From 02/2017 to 07/2019, 135 patients with left-sided breast cancer were selected and prepared for radiotherapy in DIBH. 99 received radiotherapy for the breast alone and 36 for the breast including the lymphatic drainage (RNI). Treatment plans DIBH and free breathing (FB) were calculated. Dosimetrical analyses were performed and criteria were defined to assess whether a patient would dosimetrically profit from DIBH. Results: Of the 135 patients, 97 received a DIBH planning CT and 72 were selected for treatment in DIBH according to predefined criteria. When using DIBH there was a mean reduction of the DmeanHeart of 2.8 Gy and DmeanLAD of 4.2 Gy. seven patients did not benefit from DIBH regarding DmeanHeart, 23 regarding DmeanLAD. For the left lung the V20Gy was reduced by 4.9%, the V30Gy by 2.7% with 15 and 29 patients not benefitting from DIBH, respectively. In the 25 patients treated in FB, the benefit of DIBH would have been lower than for patients treated with DIBH (ΔDmeanHeart0.7 Gy vs 3.4 Gy). Conclusion: Dosimetrically, DIBH is no “one fits all” approach. However, there is a statistically significant benefit when looking at a larger patient population. DIBH should be used for treatment of left-sided breast cancer in patients fit for DIBH. Advances in knowledge: This analysis offers a well-designed dosimetrical analysis in patients treated with DIBH radiotherapy in an “every day” cohort.

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