Extract
According to the neural gating model of respiratory sensations, breathing occurs under normal conditions automatically without reaching consciousness (gating-out). This neural filter mechanism prevents the brain from being flooded with irrelevant respiratory sensations leaving sufficient neural processing capacities for everyday activities [1, 2]. However, in some circumstances, breathing can become conscious either voluntarily (e.g. attention, meditation) or due to increased respiratory demand (e.g. exacerbations, respiratory disease). In such cases, respiratory information is no longer filtered out but transmitted to higher brain centres which leads to the allocation of attentional resources towards the breathing sensation and brings it to conscious awareness (gating-in) [1, 2]. Similar to the neural gating in other modalities, such as auditory/visual/somatosensory gating [3, 4], this respiratory gating mechanism is, therefore, the neural basis for monitoring respiratory functioning and a pre-requisite for subsequent adaptive behaviour, such as medication intake or physician visits. Anxiety, which is prevalent in patients with dyspnoea [1, 5], has been shown to be associated with reduced neural gating of respiratory sensations, suggesting gating deficits to be a potential mechanism for the documented over-perception of dyspnoea in anxious individuals [6, 7]. The neural gating model of respiratory sensations implies that decreased neural gating of respiratory sensations is associated with increasing dyspnoea [4]. However, this implication has never been tested and was investigated in the present study by using respiratory-related evoked potentials (RREP) in the electroencephalogram (EEG) while additionally exploring potential effects of anxiety.
Abstract
Reduced respiratory neural gating is associated with increased dyspnoea, particularly in high anxious individuals http://ow.ly/xW4B30k34KR
Acknowledgement
We thank Thierry Troosters for his valuable and critical evaluation of the present findings and previous versions of this manuscript.
Footnotes
Author contributions: A. von Leupoldt, P. Davenport, O. Van den Bergh, I. Van Diest, J. Sucec and M. Herzog conceptualised the research design and research protocol. M. Herzog and J. Sucec were responsible for the data collection. M. Herzog, J. Sucec and A. von Leupoldt were responsible for the statistical analysis. M. Herzog, J. Sucec and A. von Leupoldt had access to all the data in the study and take responsibility for the integrity of the data as well as the data analysis. M. Herzog and J. Sucec created the figure. J. Sucec, M. Herzog and A. von Leupoldt wrote the manuscript. J. Sucec, M. Herzog, A. von Leupoldt, I. Van Diest, O. Van den Bergh, P-Y.S. Chan and P. Davenport provided feedback on the protocol, interpretation of the study results and on the manuscript. All authors read and approved the final version.
Conflict of interest: A. von Leupoldt reports grants from Research Fund KU Leuven, Belgium (research grants: STRT/13/002 and DBOF/14/021), Herculesstichting, Belgium (research infrastructure grant: AKUL/13/07), the Flemish Government, Belgium (long-term structural research funding Methusalem grant: METH/15/011), and Research Foundation – Flanders, Belgium (research grant: G0A3718N), during the conduct of the study.
Support statement: This study was supported by grants from the Research Fund KU Leuven, Belgium (STRT/13/002 and DBOF/14/021), the Research Foundation – Flanders, Belgium (G0A3718N), by an infrastructure grant from the Herculesstichting, Belgium (AKUL/13/07) and by the “Asthenes” long-term structural funding Methusalem grant (METH/15/011) by the Flemish Government, Belgium. The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the manuscript. M. Herzog, J. Sucec and A. von Leupoldt had full access to all data. All authors had the final responsibility for the decision to submit the manuscript for publication. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received March 20, 2018.
- Accepted May 11, 2018.
- Copyright ©ERS 2018