No abstract

Dyspnea (=breathlessness) is an aversive and threatening symptom in various prevalent diseases. Established treatment procedures aim for behavioral changes in dyspneic patients in order to treat dyspnea successfully. To achieve these behavioral changes, response inhibition as one key executive function for goal-directed behavior is an important prerequisite. However, the impact of dyspnea on response inhibition is widely unknown. Therefore, the present study aimed at testing whether experimentally induced dyspnea would impair response inhibition. Thirty-six healthy participants performed the color-word Stroop task during an unloaded baseline and a resistive load-induced dyspnea condition. Response inhibition was investigated using behavioral measures (reaction time, accuracy) and, based on literature, the late positive complex (LPC) in the electroencephalogram. Furthermore, the N400 was investigated in an exploratory analysis. The results showed significantly reduced accuracy for incongruent compared to congruent color-words in the Stroop task during the dyspnea condition (p < .001) which was paralleled by a smaller LPC and a more negative centro-parietal N400 for incongruent color-words during the dyspnea compared to the baseline condition (p < .05). Possibly, during dyspnea more neural resources are allocated towards the semantic processing of incongruent color-words indexed as the N400 which are then not available for the partly overlapping LPC as an index for response inhibition. These findings demonstrate that resistive load-induced dyspnea has an impairing effect on response inhibition in healthy participants, both in terms of behavioral performance and respective neural processing. This might impair treatment efforts aimed at behavioral changes in patients suffering from dyspnea.

Dyspnoea is usually caused by diagnosable cardiorespiratory mechanisms. However, frequently dyspnoea relates only weakly or not at all to cardiorespiratory functioning, suggesting that additional neuropsychosocial processes contribute to its experience. We tested whether the mere observation of dyspnoea in others constitutes such a process and would elicit dyspnoea, negative affect and increased brain responses in the observer.In three studies, series of pictures and videos were presented, which either depicted persons suffering from dyspnoea or nondyspnoeic control stimuli. Self-reports of dyspnoea and affective state were obtained in all studies. Additionally, respiratory variables and brain responses during picture viewing (late positive potentials in electroencephalograms) were measured in one study.In all studies, dyspnoea-related pictures and videos elicited mild-to-moderate dyspnoea and increased negative affect compared to control stimuli. This was paralleled by increased late positive potentials for dyspnoea-related pictures while respiratory variables did not change. Moreover, increased dyspnoea correlated modestly with higher levels of empathy in observers.The present results demonstrate that observing dyspnoea in others elicits mild-to-moderate dyspnoea, negative affect, and increased brain responses in the absence of respiratory changes. This vicarious dyspnoea has clinical relevance, as it might increase suffering in the family and medical caregivers of dyspnoeic patients.

Dyspnea (breathlessness) is a threatening and aversive bodily sensation and a major symptom of various diseases. It has been suggested to impair several aspects of functioning in affected patients, but experimental proof for this assumption is widely absent. Error processing is an important domain of functioning and has intensively been studied using electrophysiological measures. Specifically, the error-related negativity (ERN) has been suggested to reflect early performance monitoring and error detection, while the error positivity (Pe) has been linked to subsequent error awareness. So far, little is known about the effects of anticipated or perceived dyspnea on error processing. Therefore, in 49 healthy participants, we studied the effects of experimentally induced dyspnea and threat of dyspnea on the ERN/Pe and behavioral task performance. Participants performed the arrowhead version of the flanker task during three experimental conditions: an unloaded baseline condition, a dyspnea condition, and a threat of dyspnea condition. Dyspnea was induced by breathing through inspiratory resistive loads, while high-density EEG was continuously measured. No differences in task performance (reaction times, error rates) and ERN mean amplitudes were found between conditions. However, mean amplitudes for the Pe differed between conditions with smaller Pe amplitudes during threat of dyspnea compared to baseline and dyspnea conditions, with the latter two conditions showing no difference. These results may suggest that threat of dyspnea, but not dyspnea itself, reduces error awareness, while both seem to have no impact on early error processing and related behavioral performance.