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Dehdar K, Raoufy MR. Brain structural and functional alterations related to anxiety in allergic asthma. Brain Res Bull 2023; 202:110727. [PMID: 37562517 DOI: 10.1016/j.brainresbull.2023.110727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
Psychiatric disorders are common in patients with allergic asthma, and they can have a significant impact on their quality of life and disease control. Recent studies have suggested that there may be potential immune-brain communication mechanisms in asthma, which can activate inflammatory responses in different brain areas, leading to structural and functional alterations and behavioral changes. However, the precise mechanisms underlying these alterations remain unclear. In this paper, we comprehensively review the relevant research on asthma-induced brain structural and functional alterations that lead to the initiation and promotion of anxiety. We summarize the possible pathways for peripheral inflammation to affect the brain's structure and function. Our review highlights the importance of addressing neuropsychiatric disorders in the clinical guidelines of asthma, to improve the quality of life of these patients. We suggest that a better understanding of the mechanisms underlying psychiatric comorbidities in asthma could lead to the development of more effective treatments for these patients.
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Affiliation(s)
- Kolsoum Dehdar
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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2
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Baljet E, Luijks H, van den Bemt L, Schermer TR. Chronic comorbid conditions and asthma exacerbation occurrence in a general population sample. NPJ Prim Care Respir Med 2023; 33:29. [PMID: 37567896 PMCID: PMC10421910 DOI: 10.1038/s41533-023-00350-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
Chronic comorbid conditions are common in adults with asthma, and some may influence a patient's asthma exacerbation risk. We explored associations between eighteen chronic comorbid conditions and asthma exacerbation occurrence in adults with asthma in a cross-sectional study nested within a cohort study using data from the two-yearly US National Health and Nutrition Examination Survey (NHANES) program. Data of 2387 adults with self-reported doctor-diagnosed current asthma from the 2007 to 2018 NHANES surveys were selected. Investigated chronic comorbidities were: angina pectoris; congestive heart failure; coronary heart disease; depression; diabetes mellitus; soft and hard drug use; gastroesophageal reflux; gout; history of heart attack; history of stroke; hypercholesterolemia; hypertension; kidney failure; liver conditions; obesity; rheumatoid arthritis; and thyroid problems. Outcome was defined as asthma exacerbation category: no, moderate, or severe exacerbation(s) in the past year. Ordinal logistic regression analysis with correction for potential confounders was used to estimate odds ratios (OR) for moderate or severe exacerbations. Observed associations with increased severe asthma exacerbation occurrence were: obesity (OR = 1.67; 95% confidence interval 1.24, 2.26), and rheumatoid arthritis (OR = 1.55; 1.04, 2.30). History of stroke (OR = 1.95; 1.22, 3.11) and rheumatoid arthritis (OR = 1.33; 1.00, 1.75) showed associations with increased moderate exacerbation occurrence. Age-stratified analysis showed soft drug use, obesity, depression, thyroid problems, and rheumatoid arthritis to be associated with moderate and/or severe exacerbation occurrence in one or more 10-year age strata. In conclusion, several chronic comorbid conditions were associated with asthma exacerbation occurrence, which confirms but also complements previous studies. Our observations contribute to understanding exacerbation risk estimation and, ultimately, personalized asthma management.
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Affiliation(s)
- Emma Baljet
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hilde Luijks
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- General Practice Valkenburg, Valkenburg, The Netherlands
| | - Lisette van den Bemt
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tjard R Schermer
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
- Science Office, Gelre Hospitals, Apeldoorn, The Netherlands.
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3
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Dehdar K, Raoufy MR. Effects of inhaled corticosteroids on brain volumetry, depression and anxiety-like behaviors in a rat model of asthma. Respir Physiol Neurobiol 2023:104121. [PMID: 37473791 DOI: 10.1016/j.resp.2023.104121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023]
Abstract
Brain functional deficits have been reported in asthma patients which can result in behavioral disorders like depression and anxiety. These deficits may be associated with factors like resistance to treatment, incorrect self-evaluation, and inadequate self-control. However, changes in the brain volume in allergic asthma and the effects of inhaled corticosteroids, the most common anti-inflammatory agents for asthma treatment, on these alterations remain largely unclear. Here, we evaluated depression and anxiety-like behavior as well as volume changes in different brain area, using magnetic resonance imaging in an animal model of allergic asthma with pretreatment of inhaled fluticasone propionate. Asthma-induced behavioral changes were partially, but not completely, prevented by pretreatment with inhaled fluticasone propionate. Volumetry findings showed that the allergen decreased volumes of the corpus callosum and subcortical white matter, as well as the septal region and hippocampus (especially CA1 and fimbria). However, volumes of neocortex, insular, and anterior cingulate cortex increased in asthmatic rats compared to controls. Namely, pretreatment with inhaled fluticasone propionate partially prevented asthma-induced brain volume changes, but not completely. These findings suggest that asthma is associated with structural alterations in the brain, which may contribute to the induction of psychological disorders. Thus, considering brain changes in the clinical assessments could have important implications for asthma treatment.
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Affiliation(s)
- Kolsoum Dehdar
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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4
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Dehdar K, Salimi M, Tabasi F, Dehghan S, Sumiyoshi A, Garousi M, Jamaati H, Javan M, Reza Raoufy M. Allergen induces depression-like behavior in association with altered prefrontal-hippocampal circuit in male rats. Neuroscience 2023:S0306-4522(23)00254-3. [PMID: 37286161 DOI: 10.1016/j.neuroscience.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
Allergic asthma is a common chronic inflammatory condition associated with psychiatric comorbidities. Notably depression, correlated with adverse outcomes in asthmatic patients. Peripheral inflammation's role in depression has been shown previously. However, evidence regarding the effects of allergic asthma on the medial prefrontal cortex (mPFC)-ventral hippocampus (vHipp) interactions, an important neurocircuitry in affective regulation, is yet to be demonstrated. Herein, we investigated the effects of allergen exposure in sensitized rats on the immunoreactivity of glial cells, depression-like behavior, brain regions volume, as well as activity and connectivity of the mPFC-vHipp circuit. We found that allergen-induced depressive-like behavior was associated with more activated microglia and astrocytes in mPFC and vHipp, as well as reduced hippocampus volume. Intriguingly, depressive-like behavior was negatively correlated with mPFC and hippocampus volumes in the allergen-exposed group. Moreover, mPFC and vHipp activity were altered in asthmatic animals. Allergen disrupted the strength and direction of functional connectivity in the mPFC-vHipp circuit so that, unlike normal conditions, mPFC causes and modulates vHipp activity. Our results provide new insight into the underlying mechanism of allergic inflammation-induced psychiatric disorders, aiming to develop new interventions and therapeutic approaches for improving asthma complications.
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Affiliation(s)
- Kolsoum Dehdar
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Salimi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farhad Tabasi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Institute for Brain Sciences and Cognition, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Samaneh Dehghan
- Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran; Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Akira Sumiyoshi
- Institute of Development, Aging and Cancer, Tohoku University, Seiryo-machi, Aoba-ku, Sendai, Japan; National Institutes for Quantum and Radiological Science and Technology, Anagawa, Inage-ku, Chiba, Japan
| | - Mani Garousi
- Department of Electrical and Engineering, Tarbiat Modares University, Tehran, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Javan
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Institute for Brain Sciences and Cognition, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Institute for Brain Sciences and Cognition, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Kubysheva NI, Eliseeva TI, Postnikova LB, Boldina MV, Gorobets EA, Novikov VV, Khramova RN, Karaulov AV. Cognitive Impairments in Patients with Bronchial Asthma. Bull Exp Biol Med 2023; 174:585-588. [PMID: 37040035 DOI: 10.1007/s10517-023-05751-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Indexed: 04/12/2023]
Abstract
The course of bronchial asthma can be accompanied by cognitive impairments. However, the relationship between cognitive dysfunction and asthma has not been fully revealed, nor has it been fully established what causes cognitive impairments in patients with asthma. There is an opinion that transient hypoxia and persistent systemic inflammation with insufficient control of bronchial asthma can be accompanied by neurotoxicity in relation to the hippocampus and indirectly lead to deterioration of cognitive functions. Comorbid conditions, such as obesity, allergic rhinitis, and depressive states can increase cognitive dysfunction in asthmatics. The review considers the pathophysiology of cognitive dysfunction in patients with bronchial asthma, as well as the impact of comorbid conditions on the cognitive status. This information will allow systematizing the available knowledge about the state of cognitive functions in asthma for timely detection and correction of their impairments and, ultimately, optimization of the management of these patients.
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Affiliation(s)
- N I Kubysheva
- Kazan (Volga region) Federal University, Kazan, Republic of Tatarstan, Russia.
| | - T I Eliseeva
- Privolzhsky Research Medical University, Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | | | - M V Boldina
- Privolzhsky Research Medical University, Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | - E A Gorobets
- Kazan (Volga region) Federal University, Kazan, Republic of Tatarstan, Russia
| | - V V Novikov
- I. N. Blokhina Nizhny Novgorod Research Institute of Epidemiology and Microbiology, Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Nizhny Novgorod, Russia
| | - R N Khramova
- Privolzhsky Research Medical University, Ministry of Health of the Russian Federation, Nizhny Novgorod, Russia
| | - A V Karaulov
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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Kroll JL, Ritz T. Asthma, the central nervous system, and neurocognition: Current findings, potential mechanisms, and treatment implications. Neurosci Biobehav Rev 2023; 146:105063. [PMID: 36708797 DOI: 10.1016/j.neubiorev.2023.105063] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 01/26/2023]
Abstract
Accumulating behavioral evidence suggests that asthma is associated with cognitive deficits. A number of studies have identified potential biological contributions to cognition in asthma; however, mechanistic pathways of central nervous system (CNS) involvement in asthma are yet to be established. We therefore conducted a literature review to identify studies examining potential CNS contributions to cognition in asthma. In this review, we discuss our general understanding of the CNS in asthma in the context of cognitive performance and outline a working model of mechanistic pathways linking the proposed neural influences of asthma pathology with cognition. To this extent, we incorporate neural, behavioral, psychological, social and environmental factors. Finally, we underscore the clinical significance of the CNS and neurocognitive sequelae in asthma, highlighting potential opportunities for routine monitoring, therapeutic intervention, and recommend key areas for future research.
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Affiliation(s)
- Juliet L Kroll
- Department of Psychology, Southern Methodist University, Dallas, TX, USA; Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
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Multi-dimensional analyses of the associations between depression, nocturnal awakening and asthmatic outcomes. J Affect Disord 2023; 323:21-29. [PMID: 36427647 DOI: 10.1016/j.jad.2022.11.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression plays an important role in the occurrence and development of asthma. Nocturnal awakening secondary to asthma is a crucial sign of the deterioration of asthmatic outcomes. This study plans to determine the associations between depression, nocturnal awakening and asthmatic outcomes by using multi-dimensional analyses. METHODS Study population came from the Adult Asthma Call-Back Survey 2013-2017. Multivariable regression analysis with binomial or Poisson models, dose-dependent analysis and mediation analysis were used to explore the associations between depression and nocturnal awakening with asthmatic episodes/attacks, emergency room (ER) and hospital visits. RESULTS 18,684 physician-diagnosis asthmatics were included into this study. This population consisted of 31.4 % with nocturnal awakening and 37.6 % with depression. Multivariable binomial analyses suggested that nocturnal awakening and depression were positively associated with asthmatic episodes/attacks and ER visits. Dose-dependent analyses demonstrated that the increase of nocturnal awakening was positively associated with the increase of depression and three asthmatic outcomes. Asthmatics with depression had the higher prevalence (adjusted OR = 1.17, 95%CI: 1.08-1.27) and frequency (adjusted RR = 1.08, 95%CI: 1.07-1.10) of nocturnal awakening than those without depression. Mediation analyses suggested that clarification of verbiage denoted trivial effect of depression on the associations between nocturnal awakening with asthmatic outcomes, while nocturnal awakening mildly mediated these associations between depression with asthmatic episodes/attacks (15.26 %, 95%CI: 7.29 %-28.7 %) and ER visits (13.29 %, 95%CI: 5.33 %-44.12 %). LIMITATION The cross-sectional nature limited inferences on causality. CONCLUSIONS Our findings showed that depression and nocturnal awakening might affect asthmatic outcomes. Nocturnal awakening harbored the mediated effect in the correlations between depression and asthmatic outcomes.
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Wang T, Huang X, Wang J. Asthma's effect on brain connectivity and cognitive decline. Front Neurol 2023; 13:1065942. [PMID: 36818725 PMCID: PMC9936195 DOI: 10.3389/fneur.2022.1065942] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/29/2022] [Indexed: 02/05/2023] Open
Abstract
Objective To investigate the changes in dynamic voxel mirror homotopy connection (dVMHC) between cerebral hemispheres in patients with asthma. Methods Our study was designed using a case-control method. A total of 31 subjects with BA and 31 healthy subjects with matching basic information were examined using rsfMRI. We also calculated and obtained the dVMHC value between the cerebral cortexes. Results Compared with the normal control group, the dVMHC of the lingual gyrus (Ling) and the calcarine sulcus (CAL), which represented the visual network (VN), increased significantly in the asthma group, while the dVMHC of the medial superior frontal gyrus (MSFG), the anterior/middle/posterior cingulate gyrus (A/M/PCG), and the supplementary motor area (SMA) of the sensorimotor network decreased significantly in the asthma group. Conclusion This study showed that the ability of emotion regulation and the efficiency of visual and cognitive information processing in patients with BA was lower than in those in the HC group. The dVMHC analysis can be used to sensitively evaluate oxygen saturation, visual function changes, and attention bias caused by emotional disorders in patients with asthma, as well as to predict airway hyperresponsiveness, inflammatory progression, and dyspnea.
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Affiliation(s)
- Tao Wang
- Medical College of Nanchang University, Nanchang, China,The Second Department of Respiratory Disease, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jun Wang
- The Second Department of Respiratory Disease, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China,*Correspondence: Jun Wang ✉
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Asthma Induces Psychiatric Impairments in Association With Default Mode and Salience Networks Alteration: A Resting-state EEG Study. Respir Physiol Neurobiol 2022; 300:103870. [DOI: 10.1016/j.resp.2022.103870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/19/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
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Zhang Y, Kong Y, Yang Y, Yin Y, Hou Z, Xu Z, Yuan Y. Asthma-Specific Temporal Variability Reveals the Effect of Group Cognitive Behavior Therapy in Asthmatic Patients. Front Neurol 2021; 12:615820. [PMID: 33776882 PMCID: PMC7994749 DOI: 10.3389/fneur.2021.615820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Group cognitive behavior therapy (GCBT) is a successful therapy for asthma. However, the neural biomarker of GCBT which could be used in clinic remains unclear. The temporal variability is a novel concept to characterize the dynamic functional connectivity (FC), which has many advantages as biomarker. Therefore, the aim of this study is to explore the potential difference of temporal variability between asthmatic patients and healthy controls, then determine the different patterns of temporal variability between pre- and post-treatment group and reveal the relationship between the variability and the symptoms improvement reduced by GCBT. Methods: At baseline, 40 asthmatic patients and 40 matched controls received resting-state functional magnetic resonance imaging (fMRI) scans and clinical assessments. After 8 weeks of GCBT treatment, 17 patients received fMRI scans, and assessments again. Temporal variability at baseline and post-treatment were calculated for further analysis. Results: Compared with controls, asthmatic patients showed widespread decreases in temporal variability. Moreover, the variability in both right caudate and left putamen were positively correlated with asthma control level. After GCBT, asthma control level and depression of patients were improved. Meanwhile, compared with pre-GCBT, patients after treatment showed lower variability in left opercular of Rolandic, right parahippocampal gyrus and right lingual gyrus, as well as higher variability in left temporal pole. Variability in regions which were found abnormal at baseline did not exhibit significant differences between post-GCBT and controls. Conclusions: Asthma-specific changes of dynamic functional connectivity may serve as promising underpinnings of GCBT for asthma. Clinical Trial Registration: http://www.chictr.org.cn/index.aspx, identifier: Chi-CTR-15007442.
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Affiliation(s)
- Yuqun Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.,Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Youyong Kong
- Lab of Image Science and Technology, Key Laboratory of Computer Network and Information Integration, School of Computer Science and Engineering, Ministry of Education, Southeast University, Nanjing, China
| | - Yuan Yang
- Department of Respiratory, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingyin Yin
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhi Xu
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatic and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Zhang Y, Ma K, Yang Y, Yin Y, Hou Z, Zhang D, Yuan Y. Predicting Response to Group Cognitive Behavioral Therapy in Asthma by a Small Number of Abnormal Resting-State Functional Connections. Front Neurosci 2020; 14:575771. [PMID: 33328851 PMCID: PMC7732460 DOI: 10.3389/fnins.2020.575771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/27/2020] [Indexed: 11/13/2022] Open
Abstract
Group cognitive behavioral therapy (GCBT) is a successful psychotherapy for asthma. However, response varies considerably among individuals, and identifying biomarkers of GCBT has been challenging. Thus, the aim of this study was to predict an individual's potential response by using machine learning algorithms and functional connectivity (FC) and to improve the personalized treatment of GCBT. We use the lasso method to make the feature selection in the functional connections between brain regions, and we utilize t-test method to test the significant difference of these selected features. The feature selections are performed between controls (size = 20) and pre-GCBT patients (size = 20), pre-GCBT patients (size = 10) and post-GCBT patients (size = 10), and post-GCBT patients (size = 10) and controls (size = 10). Depending on these features, support vector classification was used to classify controls and pre- and post-GCBT patients. Pearson correlation analysis was employed to analyze the associations between clinical symptoms and the selected discriminated FCs in post-GCBT patients. At last, linear support vector regression was applied to predict the therapeutic effect of GCBT. After feature selection and significant analysis, five discriminated FC regarding neuroimaging biomarkers of GCBT were discovered, which are also correlated with clinical symptoms. Using these discriminated functional connections, we could accurately classify the patients before and after GCBT (classification accuracy, 80%) and predict the therapeutic effect of GCBT in asthma (predicted accuracy, 67.8%). The findings in this study would provide a novel sight toward GCBT response prediction and further confirm neural underpinnings of asthma. Moreover, our findings had clinical implications for personalized treatment by identifying asthmatic patients who will be appropriate for GCBT. CLINICAL TRIAL REGISTRATION The brain mechanisms of group cognitive behavioral therapy to improve the symptoms of asthma (Registration number: Chi-CTR-15007442, http://www.chictr.org.cn/index.aspx).
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Affiliation(s)
- Yuqun Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Kai Ma
- MIIT Key Laboratory of Pattern Analysis and Machine Intelligence, College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Yuan Yang
- Department of Respiratory, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Daoqiang Zhang
- MIIT Key Laboratory of Pattern Analysis and Machine Intelligence, College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Choo AL, Smith SA, Li H. Associations between stuttering, comorbid conditions and executive function in children: a population-based study. BMC Psychol 2020; 8:113. [PMID: 33129350 PMCID: PMC7603732 DOI: 10.1186/s40359-020-00481-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/22/2020] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this study was to investigate the relationship between executive function (EF), stuttering, and comorbidity by examining children who stutter (CWS) and children who do not stutter (CWNS) with and without comorbid conditions. Data from the National Health Interview Survey were used to examine behavioral manifestations of EF, such as inattention and self-regulation, in CWS and CWNS. Methods The sample included 2258 CWS (girls = 638, boys = 1620), and 117,725 CWNS (girls = 57,512; boys = 60,213). EF, and the presence of stuttering and comorbid conditions were based on parent report. Descriptive statistics were used to describe the distribution of stuttering and comorbidity across group and sex. Regression analyses were to determine the effects of stuttering and comorbidity on EF, and the relationship between EF and socioemotional competence. Results Results point to weaker EF in CWS compared to CWNS. Also, having comorbid conditions was also associated with weaker EF. CWS with comorbidity showed the weakest EF compared to CWNS with and without comorbidity, and CWS without comorbidity. Children with stronger EF showed higher socioemotional competence. A majority (60.32%) of CWS had at least one other comorbid condition in addition to stuttering. Boys who stutter were more likely to have comorbid conditions compared to girls who stutter. Conclusion Present findings suggest that comorbidity is a common feature in CWS. Stuttering and comorbid conditions negatively impact EF.
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Affiliation(s)
- Ai Leen Choo
- Department of Communication Sciences and Disorders, Georgia State University, 30 Pryor St SW, Atlanta, GA, 30303, USA.
| | - Sara Ashley Smith
- Department of Teaching and Learning, University of South Florida, Tampa, FL, 33620, USA
| | - Hongli Li
- Department of Educational Policy Studies, Georgia State University, 30 Pryor St SW, Atlanta, GA, 30303, USA
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13
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Li S, Lv P, He M, Zhang W, Liu J, Gong Y, Wang T, Gong Q, Ji Y, Lui S. Cerebral regional and network characteristics in asthma patients: a resting-state fMRI study. Front Med 2020; 14:792-801. [PMID: 32270434 DOI: 10.1007/s11684-020-0745-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/18/2019] [Indexed: 02/08/2023]
Abstract
Asthma is a serious health problem that involves not only the respiratory system but also the central nervous system. Previous studies identified either regional or network alterations in patients with asthma, but inconsistent results were obtained. A key question remains unclear: are the regional and neural network deficits related or are they two independent characteristics in asthma? Answering this question is the aim of this study. By collecting resting-state functional magnetic resonance imaging from 39 patients with asthma and 40 matched health controls, brain functional measures including regional activity (amplitude of low-frequency fluctuations) and neural network function (degree centrality (DC) and functional connectivity) were calculated to systematically characterize the functional alterations. Patients exhibited regional abnormities in the left angular gyrus, right precuneus, and inferior temporal gyrus within the default mode network. Network abnormalities involved both the sensorimotor network and visual network with key regions including the superior frontal gyrus and occipital lobes. Altered DC in the lingual gyrus was correlated with the degree of airway obstruction. This study elucidated different patterns of regional and network changes, thereby suggesting that the two parameters reflect different brain characteristics of asthma. These findings provide evidence for further understanding the potential cerebral alterations in the pathophysiology of asthma.
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Affiliation(s)
- Siyi Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Peilin Lv
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Min He
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wenjing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Jieke Liu
- Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Yao Gong
- Department of Geriatric Psychiatry, The Fourth People's Hospital of Chengdu, Chengdu, 610036, China
| | - Ting Wang
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yulin Ji
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.
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14
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Gao X, Xiao Y, Lv P, Zhang W, Gong Y, Wang T, Gong Q, Ji Y, Lui S. Altered brain network integrity in patients with asthma: A structural connectomic diffusion tensor imaging study. Respir Physiol Neurobiol 2019; 266:89-94. [PMID: 31085322 DOI: 10.1016/j.resp.2019.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 02/05/2023]
Abstract
Brain functional deficits had been reported in asthma patients. These deficits may be related to treatment resistance, inaccurate self-assessment and poor self-management. However, changes of the structural brain network in asthma patients remain largely unclear. Diffusion tensor imaging were acquired from 54 asthmatic patients and 44 controls. Then we calculated all the participants' structural network metrics. All the participants underwent the test of Hamilton Rating Scale for Depression and Anxiety as well as a lung function. Multiple linear correlation analyses were conducted. At the global level, asthma patients had a higher path length and lower global efficiency than controls, implying a shift toward regular networks. At the local level, asthma patients exhibited abnormal nodal connectivity with other nodes involved the fronto-limbic regions. Our findings highlight more locally segregated but less efficiently integrated structural networks, particularly involving frontal-limbic networks, in asthmatic patients. These findings provide important evidence to support the role of brain networks in the pathophysiology of asthma.
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Affiliation(s)
- Xin Gao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China; Department of Radiology, People's Hospital of Deyang City, Deyang, China
| | - Yuan Xiao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Peilin Lv
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wenjing Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Gong
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Ting Wang
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yulin Ji
- Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
| | - Su Lui
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
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15
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Baptist AP, Busse PJ. Asthma Over the Age of 65: All's Well That Ends Well. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:764-773. [PMID: 29747982 PMCID: PMC5951417 DOI: 10.1016/j.jaip.2018.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/29/2018] [Accepted: 02/03/2018] [Indexed: 12/11/2022]
Abstract
Asthma in older adults (often classified as those 65 years or older) is relatively common, underdiagnosed, and suboptimally treated. It is an important health problem, as the population of the United States continues to age. Unfortunately, asthma morbidity and mortality rates are highest in this age group. Alterations in the innate and adaptive immune responses occur with aging, and contribute to pathophysiologic differences and subsequent treatment challenges. The symptoms of asthma may differ from those in younger populations, and often include fatigue. There are unique factors that can complicate asthma management among older adults, including comorbidities, menopause, caregiver roles, and depression. Pharmacologic therapies are often not as effective as in younger populations, and may have greater side effects. Spirometry, peak flow measurements, and asthma education are typically underused, and may contribute to delays in diagnosis as well as worse outcomes. There are specific strategies that health care providers can take to improve the care of older adults with asthma.
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Affiliation(s)
- Alan P Baptist
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, Mich.
| | - Paula J Busse
- Icahn School of Medicine at Mount Sinai, New York, NY
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16
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Bian R, Zhang Y, Yang Y, Yin Y, Zhao X, Chen H, Yuan Y. White Matter Integrity Disruptions Correlate With Cognitive Impairments in Asthma. J Magn Reson Imaging 2018; 48:748-756. [PMID: 29356252 DOI: 10.1002/jmri.25946] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive impairments are common in asthma, which is a serious global health problem characterized by chronic airway inflammation. However, the underlying neuromechanism is still unclear. PURPOSE/HYPOTHESIS To investigate the neuromechanism underlying cognitive impairments of asthma. We hypothesized that asthma patients exhibit altered white matter (WM) microstructures, which may contribute to their cognitive impairments. STUDY TYPE Case-control study. SUBJECTS 37 patients with asthma (14 male) and 31 healthy controls (10 male). FIELD STRENGTH/SEQUENCE Diffusion tensor imaging (DTI) covering the whole brain was acquired on a 3.0T scanner using a single-shot echo planar imaging sequence. ASSESSMENT A DTI with tract-based spatial statistics (TBSS) approach was used to investigate the whole-brain differences in the WM fractional anisotropy (FA) values. STATISTICAL TESTS Demographic and neuropsychological data were performed using two independent sample t-test or chi-square test or Mann-Whitney rank test. The relationship between cognitive impairments and WM abnormalities was studied using correlation analyses. RESULTS Impairments of language ability, executive function, and visual-spatial processing and widespread WM disruptions reflected by FA reduction were found in asthma patients. The executive function was related to left forceps major, cingulum, and right uncinate fasciculus, ILF (inferior longitudinal fasciculus) positively (P < 0.05). FA abnormalities were positively correlated with duration of asthma and asthma control test (ACT) scores. DATA CONCLUSION Asthma patients display multiple cognitive impairments and universally WM integrity disruptions, among which executive dysfunction closely correlates with WM abnormalities. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Rongrong Bian
- Medical School of Southeast University, Department of Psychosomatics and Psychiatry, Zhongda Hospital, Nanjing, China
| | - Yuqun Zhang
- Medical School of Southeast University, Department of Psychosomatics and Psychiatry, Zhongda Hospital, Nanjing, China
| | - Yuan Yang
- Medical School of Southeast University, Department of Psychosomatics and Psychiatry, Zhongda Hospital, Nanjing, China
| | - Yingying Yin
- Medical School of Southeast University, Department of Psychosomatics and Psychiatry, Zhongda Hospital, Nanjing, China
| | | | - Huanxin Chen
- Key Laboratory of Cognition and Personality, Ministry of Education; School of Psychology, Southwest University, Chongqing, China
| | - Yonggui Yuan
- Medical School of Southeast University, Department of Psychosomatics and Psychiatry, Zhongda Hospital, Nanjing, China
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17
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Zhang J, Chen J, Fan C, Li J, Lin J, Yang T, Fan M. Alteration of Spontaneous Brain Activity After Hypoxia-Reoxygenation: A Resting-State fMRI Study. High Alt Med Biol 2017; 18:20-26. [PMID: 28266873 DOI: 10.1089/ham.2016.0083] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Zhang, Jiaxing, Ji Chen, Cunxiu Fan, Jinqiang Li, Jianzhong Lin, Tianhe Yang, and Ming Fan. Alteration of spontaneous brain activity after hypoxia-reoxygenation: A resting-state fMRI study. High Alt Med Biol. 18:20-26, 2017.-The present study was designed to investigate the effect of hypoxia-reoxygenation on the spontaneous neuronal activity in brain. Sixteen sea-level (SL) soldiers (20.5 ± 0.7 years), who garrisoned the frontiers in high altitude (HA) (2300-4400 m) for two years and subsequently descended to sea level for one to seven days, were recruited. Control group consisted of 16 matched SL natives. The amplitude of low-frequency fluctuations (ALFF) of regional brain functional magnetic resonance imaging signal in resting state and functional connectivity (FC) between brain regions was analyzed. HA subjects showed significant increases of ALFF at several sites within the bilateral occipital cortices and significant decreases of ALFF in the right anterior insula and extending to the caudate, putamen, inferior frontal orbital cortex, temporal pole, and superior temporal gyrus; lower ALFF values in the right insula were positively correlated with low respiratory measurements. The right insula in HA subjects had increases of FC with the right superior temporal gyrus, postcentral gyrus, rolandic operculum, supramarginal gyrus, and inferior frontal triangular area. We thus demonstrated that hypoxia-reoxygenation had influence on the spontaneous neuronal activity in brain. The decrease of insular neuronal activity may be related to the reduction of ventilatory drive, while the increase of FC with insula may indicate a central compensation.
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Affiliation(s)
- Jiaxing Zhang
- 1 Department of Physiology, Medical College of Xiamen University , Xiamen, China
| | - Ji Chen
- 1 Department of Physiology, Medical College of Xiamen University , Xiamen, China
| | - Cunxiu Fan
- 1 Department of Physiology, Medical College of Xiamen University , Xiamen, China
| | - Jinqiang Li
- 2 Department of Clinical Psychology, Gulangyu Sanatorium of PLA , Xiamen, China
| | - Jianzhong Lin
- 3 Magnetic Resonance Center, Zhongshan Hospital Xiamen University , Xiamen, China
| | - Tianhe Yang
- 3 Magnetic Resonance Center, Zhongshan Hospital Xiamen University , Xiamen, China
| | - Ming Fan
- 4 Department of Cognitive Sciences, Institute of Basic Medical Sciences , Beijing, China
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18
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Xiong X, Zhu H, Wang T, Ji Y. Altered intrinsic regional brain activity in female asthmatics with or without depressive symptoms: A resting-state functional magnetic resonance imaging study. J Asthma 2016; 53:922-9. [PMID: 27267695 DOI: 10.3109/02770903.2016.1161050] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Previous studies have suggested that asthma patients are more susceptible to anxiety or depression and have more specifically elevated depressive symptomology. These psychological factors are associated with anatomical brain changes. However, little is known about alterations in spontaneous brain activity in asthma patients with depressive symptoms. Here we hypothesized that asthma patients exhibit an altered regional spontaneous brain activity, which may contribute to their increased susceptibility to depression and poor perception of asthma symptoms. The purpose of this study was to examine spontaneous brain activity in female asthma patients using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS Eleven asthmatics without depressive symptoms (ASs), 14 asthmatics with depressive symptoms (ADs), and 15 age- and education-matched healthy controls (HCs) completed rs-fMRI. The regional homogeneity (ReHo) value was calculated based on rs-fMRI to assess local signal synchrony strength and compared among the groups. Correlation analyses were conducted between both ReHo values and clinical parameters. RESULT Compared with HCs, ASs showed a significantly increased ReHo in the right insula; whereas ADs showed a significantly decreased ReHo in the right insula, which positively correlated with nocturnal symptom score in the Asthma Control Test (r = 0.562, P = 0.036). No significant correlation was observed between the total ACT scores and right insula activities (r = 0.263, P = 0.364). CONCLUSION Decreased ReHo in the right insula may play an important role in depressive symptoms and abnormal asthma symptom perception.
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Affiliation(s)
- Xingyu Xiong
- a Department of Respiratory Medicine , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
| | - Hongru Zhu
- b Mental Health Center , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
| | - Ting Wang
- a Department of Respiratory Medicine , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
| | - Yulin Ji
- a Department of Respiratory Medicine , West China Hospital of Sichuan University , Chengdu , Sichuan Province , China
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Zhang L, Zhang X, Zheng J, Wang L, Zhang HP, Wang L, Wang G. Co-morbid psychological dysfunction is associated with a higher risk of asthma exacerbations: a systematic review and meta-analysis. J Thorac Dis 2016; 8:1257-68. [PMID: 27293845 PMCID: PMC4886028 DOI: 10.21037/jtd.2016.04.68] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 04/06/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND The longitudinal associations between psychological dysfunction (PD) and asthma exacerbations (AE) have not been adequately addressed. This study aimed to systematically assess the influence of PD on AE, and to determine whether different PD affects AE differentially. METHODS Electronic databases (PubMed, Cochrane library, Web of Science, Embase, and Ovid) were searched for prospective cohort studies on the influence of PD on AE in individuals with asthma. Relative risk (RR) and adjusted RR (RRadj) were pooled across studies. Subgroup analyses assessed the effects of different types of PD and the time-dependent response to the duration of PD exposure. RESULTS Ten articles that involved 31,432 adults with asthma with follow-up of 6.0-86.4 months were included. PD significantly increased the risk of AE [RRadj =1.06, 95% confidence interval (95%CI): 1.04-1.09, P<0.001], presenting as hospitalizations (RRadj =1.22, 95% CI: 1.12-1.34, P<0.001), unscheduled doctor visits (RR =4.26, 95% CI: 2.52-7.19), and emergency department (ED) visits (RRadj =1.06, 95% CI: 1.01-1.10, P=0.009) because of asthma. Depression significantly increased the risk of AE (RRadj =1.07, 95% CI: 1.04-1.11, P<0.001), presenting as hospitalizations (RRadj =1.26, 95% CI: 1.07-1.49, P=0.007) and ED visits (RRadj =1.06, 95% CI: 1.02-1.11, P=0.007) because of asthma. Anxiety was only associated with an increased risk of AE in pregnant women (RR =1.05, 95% CI: 1.01-1.08), possibly due to the small amount of data available on anxiety. The influence of PD on AE was only significant when the PD exposure time exceeded one year. CONCLUSIONS Co-morbid PD adversely affects AE, and there are differential effects of depression and anxiety. Asthmatic subjects with PD may benefit from more attention when establishing a treatment regimen in clinical practice.
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