Mapping the neural systems driving breathing at the transition to unconsciousness
Jesus Pujol,
Laura Blanco-Hinojo,
Héctor Ortiz,
Lluís Gallart,
Luís Moltó,
Gerard Martínez-Vilavella,
Esther Vilà,
Susana Pacreu,
Irina Adalid,
Joan Deus,
Víctor Pérez-Sola,
Juan Fernández-Candil
Affiliations
Jesus Pujol
MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, Barcelona 08003, Spain; Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain; Corresponding author at: MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, Barcelona 08003, Spain.
Laura Blanco-Hinojo
MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, Barcelona 08003, Spain; Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
Héctor Ortiz
Department of Project and Construction Engineering, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
Lluís Gallart
Department of Anesthesiology, Hospital del Mar-IMIM, Barcelona, Spain; Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain
Luís Moltó
Department of Anesthesiology, Hospital del Mar-IMIM, Barcelona, Spain
Gerard Martínez-Vilavella
MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, Barcelona 08003, Spain
Esther Vilà
Department of Anesthesiology, Hospital del Mar-IMIM, Barcelona, Spain
Susana Pacreu
Department of Anesthesiology, Hospital del Mar-IMIM, Barcelona, Spain
Irina Adalid
Department of Anesthesiology, Hospital del Mar-IMIM, Barcelona, Spain
Joan Deus
MRI Research Unit, Department of Radiology, Hospital del Mar, Passeig Marítim 25-29, Barcelona 08003, Spain; Department of Psychobiology and Methodology in Health Sciences, Autonomous University of Barcelona, Barcelona, Spain
Víctor Pérez-Sola
Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain; Hospital del Mar- IMIM and Department of Psychiatry, Institute of Neuropsychiatry and Addictions, Autonomous University of Barcelona, Barcelona, Spain
Juan Fernández-Candil
Department of Anesthesiology, Hospital del Mar-IMIM, Barcelona, Spain
After falling asleep, the brain needs to detach from waking activity and reorganize into a functionally distinct state. A functional MRI (fMRI) study has recently revealed that the transition to unconsciousness induced by propofol involves a global decline of brain activity followed by a transient reduction in cortico-subcortical coupling. We have analyzed the relationships between transitional brain activity and breathing changes as one example of a vital function that needs the brain to readapt. Thirty healthy participants were originally examined. The analysis involved the correlation between breathing and fMRI signal upon loss of consciousness. We proposed that a decrease in ventilation would be coupled to the initial decline in fMRI signal in brain areas relevant for modulating breathing in the awake state, and that the subsequent recovery would be coupled to fMRI signal in structures relevant for controlling breathing during the unconscious state. Results showed that a slight reduction in breathing from wakefulness to unconsciousness was distinctively associated with decreased activity in brain systems underlying different aspects of consciousness including the prefrontal cortex, the default mode network and somatosensory areas. Breathing recovery was distinctively coupled to activity in deep brain structures controlling basic behaviors such as the hypothalamus and amygdala. Activity in the brainstem, cerebellum and hippocampus was associated with breathing variations in both states. Therefore, our brain maps illustrate potential drives to breathe, unique to wakefulness, in the form of brain systems underlying cognitive awareness, self-awareness and sensory awareness, and to unconsciousness involving structures controlling instinctive and homeostatic behaviors.