Severe Asthma Linked to Changes in Brain Structure: ERS 2026

SEVERE asthma may be associated with measurable differences in brain structure, suggesting that the effects of persistent Type 2 inflammation could extend beyond the lungs.

Research presented at the European Respiratory Society (ERS) Congress 2026 found differences in brain white matter and specific brain regions among people with severe Type 2 asthma compared with those whose disease was milder and well controlled.

Examining the Brain in Severe Asthma

Researchers recruited 50 people with severe Type 2 asthma and compared them with 25 people with well-controlled mild-to-moderate Type 2 asthma.

Participants underwent MRI using quasi-diffusion imaging, a technique capable of examining the microscopic organisation of white matter pathways.

White matter connects different areas of the brain and allows signals to travel between regions.

The scans revealed differences in both white matter organisation and the size of specific brain structures.

People with severe asthma had less-organised white matter compared with participants whose asthma was mild-to-moderate and well controlled. Differences were also detected in areas including the hippocampus and temporal lobes.

Inflammation Associated With White Matter Changes

Importantly, researchers found that greater Type 2 inflammation was associated with more pronounced differences in brain white matter across the study population.

This raises the possibility of a biological relationship between the systemic inflammatory processes involved in severe asthma and brain health.

However, the researchers stressed that the study does not demonstrate that inflammation directly caused the observed structural differences.

Previous research has linked asthma with effects on cognition, memory and wellbeing, but less is known about whether changes in the brain differ according to asthma severity.

Could Treatment Reverse the Changes?

The researchers are now examining whether brain differences change after patients begin treatments targeting the inflammation responsible for severe Type 2 asthma.

This could help establish whether the observed differences are stable, progressive or potentially reversible.

Approximately 5–10% of people with Type 2 asthma develop severe disease, characterised by persistent symptoms, exacerbations and inflammation despite intensive treatment.

The findings therefore add to growing evidence that severe asthma should be considered a systemic condition with potential effects extending beyond the airways.

Further longitudinal research will be needed to establish the mechanisms involved and determine the clinical significance of the MRI findings.

Reference

Nava G et al. Severe asthma linked to changes in brain structure. Presented at: European Respiratory Society (ERS) Congress 2026; Barcelona, Spain; 2026.

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