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Chronic rhinosinusitis, which causes a persistent stuffy nose and headaches among other symptoms, affects 11% of people in the United States – and recent research has found a link between the disease and changes in brain activity .
The team behind the study is hoping the link will help explain some of the other common effects of persistent inflammation: difficulty concentrating, battling episodes of depression, trouble sleeping, and dizziness.
Finding a link between the underlying disease and neural processing taking place elsewhere could be essential for understanding chronic disease, as well as efforts to find better and more effective ways to treat it.
“This is the first study that links chronic sinus inflammation to a neurobiological change,” said otolaryngologist Aria Jafari, University of Washington; the team document was released in April 2021.
“We know from previous studies that patients with sinusitis often decide to see a doctor not because they have a runny nose and sinus pressure, but because the disease affects how they interact with it. They can’t be productive, thinking is hard, sleep is lousy It greatly impacts their quality of life Now we have a forward looking mechanism for what we are clinically observing.
The researchers drew on data from the Human Connectome Project to find 22 subjects living with chronic rhinosinusitis and 22 control subjects without sinus inflammation. The data from the fMRI scans were then used to compare blood flow and the activity of neurons in the brain.
In people with sinus inflammation, researchers spotted weaker functional connectivity in the fronto-parietal network (used for attention and problem solving), higher functional connectivity in the default mode network (linked to self-reference and mental wandering) and weaker functional connectivity in the salience network (which manages external stimuli, communication and social behavior).
The differences were larger in people with more severe rhinosinusitis, the team noted. Taken together, these increased and decreased activity points in the brain could be the cause of the symptoms that people report.
However, the 22 subjects with chronic rhinosinusitis showed no noticeable signs of cognitive decline on testing. As they were chosen from a group of 22-35 years old, the researchers believe that this type of decline may occur later in life – something that a longitudinal study might be able to identify.
“As subjective feelings of attention decrease, difficulty concentrating or trouble sleeping that a person with sinus inflammation experiences may be associated with subtle changes in the way the brain regions controlling these functions communicate with each other.” said Harvard University otolaryngologist Kristina Simonyan.
Current treatments for rhinosinusitis can last for several years, with the severity of the inflammation often cyclical and the sinus tissue (such as callused skin) thickening. While surgery can help, there is no guarantee that symptoms of the disease will not recur.
Although this new research does not show that chronic sinus inflammation directly cause changes in brain activity, the association is strong enough to merit further investigation: Future studies could examine how this brain activity changed after treatment for people diagnosed with chronic rhinosinusitis, for example.
For now, researchers say healthcare professionals should pay more attention to the mental health symptoms that accompany conditions like sinus inflammation studied here – and how they might manifest in the rest of the body. .
“Our care should not be limited to relieving the most obvious physical symptoms, but the entire burden of illness on patients,” Jafari explained.
The research was published in JAMA Otorhinolaryngology-Head and Neck Surgery.
A version of this article was originally published in April 2021.
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