What is the PreBotzinger complex?

The PreBötzinger Complex is a region in the brainstem identified as essential for generating the rhythmic pattern of breathing. It contains a few thousand neurons located on either side of the brainstem and works in tandem. Each breath starts with neurons in the PreBötzinger Complex becoming active, and these neurons then communicate with the motor neurons that go to the diaphragm and exterior intercostals, initiating the inspiratory effort. When the activity in the PreBötzinger Complex stops, inspiration ends, and exhalation begins as the lung and ribcage passively recoil 1 .

Jack Feldman, who played a critical role in its discovery, described the PreBötzinger Complex as the primary source for rhythmic respiratory movements controlling both inhalation and exhalation. The identification of this area allowed for further studies on breathing, sighing, and its disruption in breathing-related diseases 2.

According to Andrew Huberman, the PreBötzinger Complex plays a critical role in unconscious breathing patterns such as breathing during sleep or when not consciously thinking about breathing. Its dysfunction is implicated in conditions such as Sudden Infant Death Syndrome (SIDS) and opioid overdose deaths, as opioids can inhibit the neurons within this complex, leading to cessation of breathing 3.