Alteration in functional-structural connectivities of insula is associated with hypoxic ventilation
6 affiliations
- 1School of Education and Psychology, Minnan Normal University, Zhangzhou, China
- 2Jiading Branch of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- 3Physical Education Institute, Jimei University, Xiamen, China
- 4Institute of High Altitude Medicine, Tibet Autonomous Region People’s Hospital, Tibet Autonomous Region, China
- 5Department of Radiology, School of Medicine, Zhongshan Hospital of Xiamen University, Xiamen, China
- 6Institute of Brain Disease and Cognition, School of Medicine, Xiamen University, Xiamen, China
Abstract
Background Hypoxia elicits ventilatory adaptation, and the anterior insula, a hub for interoceptive and exteroceptive integration, is highly vulnerable to hypoxic stress. We hypothesised that it mediates hypoxia-related ventilatory regulation.Methods Thirty-one college students completed 30 days of high altitude exposure. Respiratory function tests and multimodal MRI were conducted immediately at high altitude. Moreover, follow-up MRI scans were performed 7 days, 2 months, and 3 months after the students returned to sea level.Results Pulmonary function (peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC%, maximal mid-expiratory flow (MMF) and minute ventilation (MV)) significantly declined after high altitude exposure. The ALFF increased in the insular cortex, with enhanced FC with the thalamus, motor cortex and postcentral cortex. FC of the left anterior insula with the thalamus was negatively correlated with FEV1 predicted values, while right lateral prefrontal insula-thalamus connectivity was positively correlated with FEV1 and MMF. FC of the anterior insula with the motor cortex and postcentral cortex was negatively correlated with PEF%, FVC and FEV1, respectively. Moreover, fibre pathways linking the anterior insular cortex with the thalamus, motor cortex and postcentral cortex showed increased fibre numbers between these brain regions. Follow-up MRI studies showed that ALFF in the anterior insular cortex was significantly increased immediately after reoxygenation and then recovered to baseline level.Conclusion The anterior insula may serve as a potential hub for integrating hypoxic signals from the thalamus and modulating motor cortex activity, which may contribute to hypoxic ventilation.
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BibTeX
@article{zhang2026alteration,
title = {{Alteration in functional-structural connectivities of insula is associated with hypoxic ventilation}},
author = {Xinjuan Zhang and Cunxiu Fan and Yanqiu Liu and Haipeng Liu and Jianzhong Lin and Jiaxing Zhang},
journal = {Pulmonology},
year = {2026},
month = nov,
doi = {10.1080/25310429.2026.2757315},
url = {https://doi.org/10.1080/25310429.2026.2757315},
note = {CC BY},
}
RIS
TY - JOUR
TI - Alteration in functional-structural connectivities of insula is associated with hypoxic ventilation
AU - Xinjuan Zhang
AU - Cunxiu Fan
AU - Yanqiu Liu
AU - Haipeng Liu
AU - Jianzhong Lin
AU - Jiaxing Zhang
PY - 2026
DA - 2026/11/04
JO - Pulmonology
DO - 10.1080/25310429.2026.2757315
UR - https://doi.org/10.1080/25310429.2026.2757315
AB - Background Hypoxia elicits ventilatory adaptation, and the anterior insula, a hub for interoceptive and exteroceptive integration, is highly vulnerable to hypoxic stress. We hypothesised that it mediates hypoxia-related ventilatory regulation.Methods Thirty-one college students completed 30 days of high altitude exposure. Respiratory function tests and multimodal MRI were conducted immediately at high altitude. Moreover, follow-up MRI scans were performed 7 days, 2 months, and 3 months after the students returned to sea level.Results Pulmonary function (peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC%, maximal mid-expiratory flow (MMF) and minute ventilation (MV)) significantly declined after high altitude exposure. The ALFF increased in the insular cortex, with enhanced FC with the thalamus, motor cortex and postcentral cortex. FC of the left anterior insula with the thalamus was negatively correlated with FEV1 predicted values, while right lateral prefrontal insula-thalamus connectivity was positively correlated with FEV1 and MMF. FC of the anterior insula with the motor cortex and postcentral cortex was negatively correlated with PEF%, FVC and FEV1, respectively. Moreover, fibre pathways linking the anterior insular cortex with the thalamus, motor cortex and postcentral cortex showed increased fibre numbers between these brain regions. Follow-up MRI studies showed that ALFF in the anterior insular cortex was significantly increased immediately after reoxygenation and then recovered to baseline level.Conclusion The anterior insula may serve as a potential hub for integrating hypoxic signals from the thalamus and modulating motor cortex activity, which may contribute to hypoxic ventilation.
SN - 2531-0437
SN - 2531-0429
ER -