Regional brain response patterns to Cheyne–Stokes breathing

• Published in: Respiratory physiology & neurobiology Vol. 150; no. 1; pp. 87 - 93
• Main Authors: Henderson, Luke A., Macey, Katherine E., Macey, Paul M., Woo, Mary A., Yan-Go, Frisca L., Harper, Ronald M.
• Format: Journal Article
• Language: English
• Published: Amsterdarm Elsevier B.V 25.01.2006; Elsevier
• Subjects: Adult; Apnea; Biological and medical sciences; Brain - blood supply; Brain - physiopathology; Brain Mapping; Cheyne-Stokes Respiration - pathology; Cheyne-Stokes Respiration - physiopathology; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Drug Combinations; Functional magnetic resonance imaging; Humans; Image Processing, Computer-Assisted - methods; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Obstructive sleep apnea; Peroxides - blood; Sleep; Sleep - physiology; Urea - analogs & derivatives; Urea - blood; Functional magnetic resonance imaging; Apnea; Sleep; Obstructive sleep apnea; Human; Respiratory disease; Central nervous system; Nuclear magnetic resonance imaging; Cheyne Stokes breathing; Encephalon; Sleep wake cycle; Respiration; Functional imaging
• ISSN: 1569-9048; 1878-1519
• DOI: 10.1016/j.resp.2005.08.007

Cheyne–Stokes breathing (CSB) results from impaired integration of sensory information with respiratory motor output; however, regions mediating the disturbed control are unknown. We examined functional magnetic resonance imaging signals during CSB within sleep to determine affected areas. Two male patients with severe obstructive sleep apnea were scanned while asleep over multiple sessions during which they exhibited CSB. Significant signal increases coincident with apneic periods emerged bilaterally in the cerebellar cortex, hippocampus, mediodorsal thalamus, frontal cortex and precentral gyrus. Signals declined bilaterally in the anterior cingulate cortex and postcentral gyrus. The reduced activation in primary sensory cortex and increased signals prior to breathing onset in the motor cortex are consistent with loss of sensory stimulation by airflow, and with anticipatory action of the motor cortex prior to initiation of breathing. Hippocampal and anterior cingulate cortex participation likely reflect previously-demonstrated roles for initiating inspiratory efforts and resolving sensory information and motor action, respectively.