Dyspnea Perception in COPD

Janssens, Thomas; Peuter, Steven De; Stans, Linda; Verleden, Geert M.; Troosters, Thierry; Decramer, Marc; Bergh, Omer Van den

doi:10.1378/chest.10-3257

Cited by 109 publications

(50 citation statements)

References 40 publications

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“…However, most previous studies examined the impact of rather unspecific forms of negative affectivity (e.g., general anxiety levels) on the anticipation and perception of dyspnea. Only recently, studies began to focus on more dyspneaspecific forms of negative affectivity including breathlessness beliefs, fear of suffocation/dyspnea, and dyspnea catastrophizing (Alius et al, 2013;Fischer et al, 2012;Janssens et al, 2011;Keil et al, 2014;K€ uhl, Kuhn, Kenn, & Rief, 2011;Pappens, Smets, Van Den Bergh, & Van Diest, 2012;Sutton, Cooper, Pimm, & Wallace, 1999). These dyspneaspecific forms of negative affectivity have been shown to contribute to several clinical outcomes even after controlling for unspecific general anxiety levels and presumably provide a more specific target for individualized therapeutic interventions (Hayen et al, 2013;von Leupoldt & Janssens, 2016).…”

Section: Introductionmentioning

confidence: 99%

Dyspnea catastrophizing and neural activations during the anticipation and perception of dyspnea

et al. 2017

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Dyspnea is an aversive symptom in various diseases. High levels of negative affectivity are typically associated with increased dyspnea and changes in its neural processing. Recently, more dyspnea-specific forms of negative affectivity such as dyspnea catastrophizing were suggested to contribute to increased perception of dyspnea beyond effects of rather unspecific negative affectivity such as general anxiety levels. The involved neural mechanisms have not yet been explored. Therefore, the present retrospective analysis examined the associations of dyspnea catastrophizing with neural activations during the anticipation and perception of dyspnea. Sixty-six healthy volunteers underwent 20 blocks of inspiratory resistive load breathing with parallel acquisition of fMRI data. Loads inducing either severe or mild dyspnea (dyspnea conditions) were presented in alternating order, with each condition being visually cued (anticipation conditions). Dyspnea catastrophizing and general trait anxiety were measured with the Breathlessness Catastrophizing Scale (BCS) and the State-Trait Anxiety Inventory, respectively. Correlating the BCS scores with neural activations during the perception of dyspnea yielded no significant results. However, during the anticipation of dyspnea, BCS scores correlated positively with activations of the anterior cingulate cortex (ACC), even after controlling for general anxiety levels. These activations in the ACC were not related to concurrent respiratory parameters. Results suggest that dyspnea catastrophizing in healthy volunteers is associated with stronger ACC recruitment during dyspnea anticipation. Given the established role of the ACC in processing affective states, affect regulation, and antinociception, this might reflect increased affective and/or top-down modulatory processing in individuals with higher dyspnea catastrophizing when anticipating dyspnea.

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Section: Introductionmentioning

confidence: 99%

Dyspnea catastrophizing and neural activations during the anticipation and perception of dyspnea

et al. 2017

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“…Recently, research has begun to expand beyond broad psychopathological constructs, such as depression and anxiety, into particular affective and cognitive processes that may influence how one attends and responds specifically to the symptom of dyspnea [13,14]. It has been proposed that breathlessness catastrophizing is one such cognitive process that warrants further investigation [7,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…More generally, a fear-avoidance model applied to COPD would suggest that individuals who catastrophize would engage in physical therapy at suboptimal levels and exhibit a more general unwillingness to engage in programs that are heavily focused on exercise [14]. However, there are limited options for assessing catastrophizing in individuals with COPD, so there has been little formal investigation of these hypotheses.…”

Section: Introductionmentioning

confidence: 99%

A Breathlessness Catastrophizing Scale for chronic obstructive pulmonary disease

Solomon

Wilson

Henderson

et al. 2015

Journal of Psychosomatic Research

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“…Contemporary models emphasize that the experience of dyspnea is strongly influenced by psychologic processes, particularly depression 3 ‐ 5 and dyspnea-related fear and anxiety. 5 ‐ 9 Although the physical sensation of dyspnea commonly originates from sensory afferent sources, including the heart, lungs, and muscles, conscious awareness of dyspnea arises in the brain. 5 ‐ 8 Repeated association between environmental cues and dyspnea may increase the salience of such cues.…”

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confidence: 99%

Dyspnea-Related Cues Engage the Prefrontal Cortex

Herigstad

Hayen

Evans

et al. 2015

Chest

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BACKGROUND:Dyspnea is the major source of disability in COPD. In COPD, environmental cues (eg, the prospect of having to climb stairs) become associated with dyspnea and may trigger dyspnea even before physical activity commences. We hypothesized that brain activation relating to such cues would be different between patients with COPD and healthy control subjects, reflecting greater engagement of emotional mechanisms in patients.METHODS:Using functional MRI (FMRI), we investigated brain responses to dyspnea-related word cues in 41 patients with COPD and 40 healthy age-matched control subjects. We combined these findings with scores on self-report questionnaires, thus linking the FMRI task with clinically relevant measures. This approach was adapted from studies in pain that enabled identification of brain networks responsible for pain processing despite absence of a physical challenge.RESULTS:Patients with COPD demonstrated activation in the medial prefrontal cortex and anterior cingulate cortex, which correlated with the visual analog scale (VAS) response to word cues. This activity independently correlated with patient responses on questionnaires of depression, fatigue, and dyspnea vigilance. Activation in the anterior insula, lateral prefrontal cortex, and precuneus correlated with the VAS dyspnea scale but not with the questionnaires.CONCLUSIONS:The findings suggest that engagement of the emotional circuitry of the brain is important for interpretation of dyspnea-related cues in COPD and is influenced by depression, fatigue, and vigilance. A heightened response to salient cues is associated with increased symptom perception in chronic pain and asthma, and the findings suggest that such mechanisms may be relevant in COPD.

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Dyspnea Perception in COPD

Cited by 109 publications

References 40 publications

Dyspnea catastrophizing and neural activations during the anticipation and perception of dyspnea

Dyspnea catastrophizing and neural activations during the anticipation and perception of dyspnea

A Breathlessness Catastrophizing Scale for chronic obstructive pulmonary disease

Dyspnea-Related Cues Engage the Prefrontal Cortex

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