RT Journal Article
SR Electronic
T1 Short-term cognitive loading deteriorates breathing pattern and gas exchange in adult patients with congenital central hypoventilation syndrome
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00408-2022
DO 10.1183/23120541.00408-2022
A1 Jessica Taytard
A1 Marie-Cécile Niérat
A1 Camille Gand
A1 Sophie Lavault
A1 Capucine Morélot-Panzini
A1 Maxime Patout
A1 Laure Serresse
A1 Nicolas Wattiez
A1 Laurence Bodineau
A1 Christian Straus
A1 Thomas Similowski
YR 2022
UL http://openres.ersjournals.com/content/early/2022/10/06/23120541.00408-2022.abstract
AB Question Human PHOX2B mutations result in life-threatening sleep-related hypoventilation (congenital central hypoventilation syndrome, CCHS). Most patients retain ventilatory activity when awake through a respiratory-related cortical network. We hypothesised that this need to mobilise cortical resources to breathe would lead to breathing-cognition interferences during cognitive loading.Patients and Methods Seven adult CCHS patients (5 women; median age 21) performed standard neuropsychological tests (Paced Auditory Serial Addition Test –calculation capacity, working memory, sustained and divided attention–; Trail Making Test –visuospatial exploration capacity, cognitive processing speed, attentional flexibility–; Corsi block-tapping test –visuospatial memory, short-term memory, working memory–), during unassisted breathing and under ventilatory support. Ventilatory variables and transcutaneous haemoglobin oxygen saturation were recorded. Cortical connectivity changes between unassisted breathing and ventilatory support were assessed using electroencephalographic recordings (EEG).Results Baseline performances were lower than expected in individuals this age. During unassisted breathing, cognitive loading coincided with increased breathing variability and decreases in oxygen saturation inversely correlated with an increasing number of apnoeic cycles/minute (rho −0.46, 95% confidence interval −0.76 to −0.06, p=0.01). During ventilatory support, cognitive tasks did not disrupt breathing pattern and were not associated with decreased oxygen saturation. Ventilatory support was associated with changes in EEG cortical connectivity but not with improved test performances.Conclusions Acute cognitive loads induce oxygen desaturation in adult CCHS patients during unassisted breathing, but not under ventilatory support. This justifies considering the use of ventilatory support during mental tasks in CCHS patients, to avoid repeated episodes of hypoxia.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Jessica TaytardConflict of interest: Marie-Cécile NiératConflict of interest: Camille GandConflict of interest: Sophie LavaultConflict of interest: Capucine Morélot-PanziniConflict of interest: Maxime PatoutConflict of interest: Laure SerresseConflict of interest: Nicolas WattiezConflict of interest: Laurence BodineauConflict of interest: Christian StrausConflict of interest: Thomas Similowski