Breathlessness in humans activates insular cortex

Neuroreport. 2000 Jul 14;11(10):2117-20. doi: 10.1097/00001756-200007140-00012.


Dyspnea (shortness of breath, breathlessness) is a major and disabling symptom of heart and lung disease. The representation of dyspnea in the cerebral cortex is unknown. In the first study designed to explore the central neural structures underlying perception of dyspnea, we evoked the perception of severe 'air hunger' in healthy subjects by restraining ventilation below spontaneous levels while holding arterial oxygen and carbon dioxide levels constant. PET revealed that air hunger activated the insular cortex. The insula is a limbic structure also activated by visceral stimuli, temperature, taste, nausea and pain. Like dyspnea, such perceptions underlie behaviors essential to homeostasis and survival.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Brain / physiology
  • Brain / physiopathology*
  • Brain Mapping
  • Cerebral Cortex / physiology
  • Cerebral Cortex / physiopathology*
  • Dyspnea / physiopathology*
  • Humans
  • Male
  • Oxygen / blood
  • Partial Pressure
  • Perception
  • Respiratory Mechanics / physiology*
  • Supine Position
  • Tidal Volume
  • Tomography, Emission-Computed


  • Oxygen