Subcortical gray matter volumes in asthma: associations with asthma duration, control, and anxiety
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Asthma as a chronic inflammatory disease can be expected to affect central nervous system structures but little is known about subcortical structures in asthma and their potential association with illness-specific outcomes and anxiety. A total of 40 young adults (20 with asthma and 20 gender- and age-matched controls) underwent high-resolution T1-weighted MRI scan, viewed short distressing film clips, and filled in questionnaires about anxious and depressed mood, as well as asthma history, control, and catastrophizing thoughts about asthma, for those with asthma. The structural scans were processed in FSL’s FIRST program to delineate subcortical structures of interest: amygdala, hippocampus, putamen, pallidum, caudate nucleus, nucleus accumbens, and thalamus. Findings showed no general reduction in subcortical gray matter volumes in asthma compared to controls. Asthma duration, asthma control, and catastrophizing of asthma and asthma attacks were negatively associated with volumes of putamen and pallidum, and to a weaker extent thalamus and amygdala, while controlling for gender, age, and corticosteroid inhaler use. In addition, stronger anxiety in response to distressing films was associated with lower volume of the pallidum, whereas general anxious and depressed mood was unrelated to subcortical structures. Thus, although there are no subcortical structural differences between young adults with asthma and healthy controls, longer asthma history, suboptimal management, and illness-related anxiety are reflected in lower gray matter volumes of subcortical structures, further emphasizing the importance of maintaining optimal asthma control.
KeywordsStructural magnetic resonance imaging Gray matter volume Asthma Limbic system Basal ganglia Asthma management Anxiety
Asthma Control Questionnaire
Catastrophizing of Asthma Scale
Central nervous system
Fractional exhaled nitric oxide
Forced expiratory volume in the 1st second
Hospital Anxiety and Depression Scale
Magnetic resonance imaging
National Heart, Lung, and Blood Institute/National Asthma Education and Prevention Program
Partial funding for this study was provided by the National Institute on Aging (NIA, R24 AG048024), the University Research Council grant (URC 413876) at Southern Methodist University (SMU), and seed funds from Dedman College at SMU. We thank Binu Thomas, Lilly Yang, and Salvador Pena (University of Texas Southwestern Medical Center, Advanced Imaging Research Center) for their help with image acquisitions; Ashton Steele, Sheenal V. Patel, Justin R. Chen, Steve Dorman, Maryam Saifi, Sharon Deol, and Julie Kim for their help in data collection; and Alexandra Kulikova and Brittany Mason for their administrative support.
Conception and design of the study: TR, ESB, and TJ; acquisition of the data: JLK and DAK; analysis and interpretation: TR, SA, and ESB; drafting the article and/or revising it critically for important intellectual content: TR, SA, JLK, TJ, AEP, DAK, and ESB; approval of the final version to be published: TR, SA, JLK, TJ, AEP, DAK, and ESB.
Partial funding for this study was provided by the National Institute on Aging (NIA, R24 AG048024), the University Research Council grant (URC 413876) at Southern Methodist University (SMU), and seed funds from Dedman College at SMU.
Compliance with ethical standards
Conflict of interest
TR, SA, JLK, TJ, AEP, and DAK, report no biomedical financial interests or potential conflicts of interest. ESB reports having received research funding from Otsuka and lecture fees from Genentech.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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