The Effects of Respiratory Muscle Training on Resting-State Brain Activity and Thoracic Mobility in Healthy Subjects: A Randomized Controlled Trial

VARDAR YAĞLI N., SAĞLAM M., Dasgin H., Karli-Oguz K.

JOURNAL OF MAGNETIC RESONANCE IMAGING, vol.57, no.2, pp.403-417, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 57 Issue: 2
  • Publication Date: 2023
  • Doi Number: 10.1002/jmri.28322
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.403-417
  • Keywords: respiratory muscle function, functional magnetic resonance imaging, healthy subjects, DEFAULT MODE, CONNECTIVITY, EXERCISE, PERCEPTION, RESPONSES, DYSPNEA, CORTEX
  • Hacettepe University Affiliated: Yes


Background Although inspiratory muscle training (IMT) is an effective intervention for improving breath perception, brain mechanisms have not been studied yet. Purpose To examine the effects of IMT on insula and default mode network (DMN) using resting-state functional MRI (RS-fMRI). Study Type Prospective. Population A total of 26 healthy participants were randomly assigned to two groups as IMT group (n = 14) and sham IMT groups (n = 12). Field Strength/Sequence A 3-T, three-dimensional T2* gradient-echo echo planar imaging sequence for RS-fMRI was obtained. Assessment The intervention group received IMT at 60% and sham group received at 15% of maximal inspiratory pressure (MIP) for 8 weeks. Pulmonary and respiratory muscle function, and breathing patterns were measured. Groups underwent RS-fMRI before and after the treatment. Statistical Tests Statistical tests were two-tailed P < 0.05 was considered statistically significant. Student's t test was used to compare the groups. One-sample t-test for each group was used to reveal pattern of functional connectivity. A statistical threshold of P < 0.001 uncorrected value was set at voxel level. We used False discovery rate (FDR)-corrected P < 0.05 cluster level. Results The IMT group showed more prominent alterations in insula and DMN connectivity than sham group. The MIP was significantly different after IMT. Respiratory rate (P = 0.344), inspiratory time (P = 0.222), expiratory time (P = 1.000), and inspiratory time/total breath time (P = 0.572) of respiratory patterns showed no significant change after IMT. All DMN components showed decreased, while insula showed increased activation significantly. Data Conclusion Differences in brain activity and connectivity may reflect improved ventilatory perception with IMT with a possible role in regulating breathing pattern by processing interoceptive signals. Evidence Level 2 Technical Efficacy Stage 4