Breathing control, brain, and bodily self-consciousness: Toward immersive digiceuticals to alleviate respiratory suffering

Impact des processus cognitifs sur la ventilation spontanée et en condition de dyspnée expérimentale

This study evaluated cognitive function and mood state with inspiratory resistance before and after maximal exercise in hypoxia. Nine healthy men (age = 25 ± 2 years) performed the Automated Neuropsychological Assessment Metrics—4th Edition (ANAM4) of the Stroop color–word test (SCWT) and total mood disturbance (TMD) before and after an incremental cycling exercise until volitional fatigue with four different inspiratory resistances (0, 1.5, 4.5, 7.5 cm H2O·L−1·s−1). There was no significant difference in the interference score of SCWT and TMD at normobaric, hypoxic conditions at four different inspiratory resistances. However, the interference score of SCWT was improved following maximal cycling exercise, whereas TMD was not improved. Inspiratory resistance did not have a deleterious effect on cognitive function and mood state in normobaric hypoxia after maximal cycling exercise. However, following maximal cycling exercise, cognitive function was improved.

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Added Inspiratory Resistance Does Not Impair Cognitive Function and Mood State

Objectives Dyspnea is a common and multidimensional experience of healthy adults and those with respiratory disorders. Due to its neural processing, it may limit or interfere with cognition, which may be examined with a dual-task paradigm. The aim of this study was to compare single-task performance of Stroop Colour and Word Test (SCWT) or inspiratory threshold loading (ITL) to their combined dual-task performance. Secondly, whether mood was related to dyspnea or cognitive performance was also evaluated. Materials & methods A virtual pre-post design examined single (SCWT and ITL) and dual-task (SCWT+ITL) performance. For ITL, a Threshold Trainer™ was used to elicit a “somewhat severe” rating of dyspnea. The SCWT required participants to indicate whether a colour-word was congruent or incongruent with its semantic meaning. The Depression, Anxiety and Stress Scale-21 (DASS-21) was completed to assess mood. Breathing frequency, Borg dyspnea rating, and breathing endurance time were ascertained. Results Thirty young healthy adults (15F, 15M; median age = 24, IQR [23–26] years) completed the study. SCWT+ITL had lower SCWT accuracy compared to SCWT alone (98.6%, [97.1–100.0] vs 99.5%, [98.6–100.0]; p = 0.009). Endurance time was not different between ITL and SCWT+ITL (14.5 minutes, [6.9–15.0]) vs 13.7 minutes, [6.1–15.0]; p = 0.59). DASS-21 scores positively correlated with dyspnea scores during ITL (rho = 0.583, p<0.001) and SCWT+ITL (rho = 0.592, p<0.001). Conclusions ITL significantly reduced dual-task performance in healthy young adults. Lower mood was associated with greater perceived dyspnea during single and dual-task ITL. Considering the prevalence of dyspnea in respiratory disorders, the findings of this dual task paradigm warrant further exploration to inform dyspnea management during daily activities.

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Dyspnea induced by inspiratory loading limits dual-tasking in healthy young adults

In healthy humans, inspiratory threshold loading deteriorates cognitive performances. This can result from motor-cognitive interference (activation of motor respiratory-related cortical networks vs...

Impact of inspiratory threshold loading on brain activity and cognitive performances in healthy humans.

Question Human PHOX2B mutations result in life-threatening sleep-related hypoventilation (congenital central hypoventilation syndrome, CCHS). Most patients retain ventilatory activity when awake through a respiratory-related cortical network. We hypothesised that this need to mobilise cortical resources to breathe would lead to breathing-cognition interferences during cognitive loading. Patients and methods Seven adult CCHS patients (five women; median age 21) performed standard neuropsychological tests (paced auditory serial addition test – calculation capacity, working memory, sustained and divided attention; trail making test – visuospatial exploration capacity, cognitive processing speed, attentional flexibility; Corsi block-tapping test – visuospatial memory, short-term memory, working memory) during unassisted breathing and under ventilatory support. Ventilatory variables and transcutaneous haemoglobin oxygen saturation were recorded. Cortical connectivity changes between unassisted breathing and ventilatory support were assessed using electroencephalographic recordings (EEG). Results Baseline performances were lower than expected in individuals of this age. During unassisted breathing, cognitive loading coincided with increased breathing variability, and decreases in oxygen saturation inversely correlated with an increasing number of apnoeic cycles per minute (rho −0.46, 95% CI −0.76 to −0.06, p=0.01). During ventilatory support, cognitive tasks did not disrupt breathing pattern and were not associated with decreased oxygen saturation. Ventilatory support was associated with changes in EEG cortical connectivity but not with improved test performances. Conclusions Acute cognitive loads induce oxygen desaturation in adult CCHS patients during unassisted breathing, but not under ventilatory support. This justifies considering the use of ventilatory support during mental tasks in CCHS patients to avoid repeated episodes of hypoxia. In adult CCHS patients, acute cognitive loads disorganise breathing and induce oxygen desaturation during unassisted breathing but not ventilatory support. Ventilatory support should be considered in this setting, to avoid repeated hypoxia. https://bit.ly/3Mlp0yH

https://openres.ersjournals.com/content/erjor/early/2022/10/06/23120541.00408-2022.full.pdf

Short-term cognitive loading deteriorates breathing pattern and gas exchange in adult patients with congenital central hypoventilation syndrome

cognitive loading deteriorates ABSTRACT Question: Human PHOX2B mutations result in life-threatening sleep-related hypoventilation (congenital central hypoventilation syndrome, CCHS). Most patients retain ventilatory . We hypothesised that activity when awake through a respiratory-related cortical network this need to mobilise cortical resources to breathe would lead to breathing-cognition interferences during cognitive loading. Patients and Methods: Seven adult CCHS patients (5 women; median age 21) performed standard neuropsychological tests (Paced Auditory Serial Addition Test –calculation capacity, working memory, sustained and divided attention–; Trail Making Test –visuospatial exploration capacity, cognitive processing speed, attentional flexibility–; Corsi block-tapping test –visuospatial memory, short-term memory, working memory–), during unassisted breathing and under ventilatory support. Ventilatory variables and transcutaneous haemoglobin oxygen saturation were recorded. Cortical connectivity changes between unassisted breathing and ventilatory support were assessed using electroencephalographic recordings (EEG). Results: Baseline performances were lower than expected in individuals this age. During unassisted breathing, cognitive loading coincided with increased breathing variability and decreases in oxygen saturation inversely correlated with an increasing number of apnoeic cycles/minute (rho -0.46, 95% confidence interval -0.76 to -0.06, p=0.01). During ventilatory support, cognitive tasks did not disrupt breathing pattern and were not associated with decreased oxygen saturation. Ventilatory support was associated with changes in EEG cortical connectivity but not with improved test performances. Conclusions: Acute cognitive loads induce oxygen desaturation in adult CCHS patients during unassisted breathing, but not under ventilatory support. This justifies considering the use of ventilatory support during mental tasks in CCHS patients, to avoid repeated episodes of hypoxia.

Camille Gand

Papers

Impact of inspiratory threshold loading on brain activity and cognitive performances in healthy humans.

Short-term cognitive loading deteriorates breathing pattern and gas exchange in adult patients with congenital central hypoventilation syndrome

Early Short-term cognitive loading deteriorates breathing pattern and gas exchange in adult patients with congenital central hypoventilation syndrome