Coupling of spatial and directional functional network connectivity reveals a physiological basis for salience network hubs in asthma.

Research findings have consistently indicated that asthma might be correlated with neural activity in brain circuits, especially the insular and anterior cingulate cortex (ACC), which are primary nodes of the salience network (SN). However, little is known about the relationships between the SN and other brain regions that are affected by asthma. Therefore, we explored the role of the SN to determine whether its neural activity was disrupted by asthma. Forty asthmatic patients and 40 well-matched healthy controls (HCs) underwent functional magnetic resonance imaging scanning and clinical assessments, including the asthma control test and 17-item Hamilton depression scale (HAMD). Altered spatial, network and temporal connections of the SN were investigated. Compared to HCs, patients showed increased functional connectivity (FC) between the dorsal ACC (dACC) and left middle frontal gyrus. In addition, network FC analysis suggested that the SN has increased connections with both the default mode network (DMN) and executive control network (ECN), which are both related to asthma. Asthma decreased the network connections between the DMN and ECN. Furthermore, Granger causality (GC) strengths from both the DMN and ECN to the bilateral anterior insula were increased in asthmatic patients. A positive correlation was found between GC strengths from the left parietal cortex to the right anterior insula and HAMD scores in asthmatic patients (r = 0.434, P = 0.005). The findings from this study suggested that the SN plays an important role in asthma. The aberrant spatial FC of the SN and its directional network connections with the DMN and ECN may contribute to the potential neural underpinnings of asthma.