Insular routing to orbitofrontal cortex enables breathing awareness

Area of Science:

• Neuroscience
• Respiratory Physiology
• Human Brain Function

Background:

• Breathing distress in humans is complex, involving pulmonary, brainstem, and higher cortical influences.
• Understanding human respiratory control is crucial, as current treatments for breathing distress are limited.
• Emotion and experience significantly shape how the brain interprets breathing signals.

Purpose of the Study:

• To investigate how the human brain detects and responds to disruptions in breathing.
• To identify the neural circuits involved in sensing and adapting to respiratory challenges.
• To explore the role of higher brain regions in respiratory awareness and distress.

Main Methods:

• Recorded intracranial cortical activity in neurosurgical patients.
• Utilized an interoceptive task with transient breathing challenges.
• Analyzed neural responses in relation to conscious detection of breathing disruptions.

Main Results:

• Early responses in the anterior insula predicted conscious detection of breathing disruptions.
• The anterior insula routed signals to orbitofrontal and premotor cortices for appraisal and compensation.
• Cortical regions preferentially encoded specific respiratory signals like inspiratory effort or airflow, mirroring brainstem processing.

Conclusions:

• A dynamic insular-frontal cortical circuit is identified for sensing and adapting to respiratory challenges.
• This circuit provides insight into the neural basis of breathing awareness.
• Findings offer potential targets for understanding and treating breathing disorders linked to neural dysfunction.