Harnessing the power of anticipation to manage respiratory-related brain suffering and ensuing dyspnoea: insights from the neurobiology of the respiratory nocebo effect

Vinckier, Fabien; Betka, Sophie; Nion, Nathalie; Serresse, Laure; Similowski, Thomas

doi:10.1183/13993003.01876-2021

Cited by 7 publications

(4 citation statements)

References 73 publications

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Section: Resultsmentioning

confidence: 99%

“…79 97 Since expectation of dyspnoea can be manipulated by an external intervention, it becomes of major importance not only to interfere with acute brain mechanisms, but also to reverse chronic conditioning to free the patient's mind from negative respiratory anticipation. 97 In oncology, the experimental tradition in placebo and nocebo effects originated in the study of anticipatory nausea in chemotherapy. The latter refers to the phenomenon whereby patients develop such strong learning between their chemotherapy context and the nausea that they begin to feel nauseous purely when they re-enter this context.…”

Section: Continuedmentioning

confidence: 99%

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Placebo and nocebo effects and mechanisms associated with pharmacological interventions: an umbrella review

Frisaldi,

Shaibani,

Benedetti

et al. 2023

BMJ Open

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ObjectivesThis review aimed to summarise the existing knowledge about placebo and nocebo effects associated with pharmacological interventions and their mechanisms.DesignUmbrella review, adopting the Assessment of Multiple Systematic Reviews 2 tool for critical appraisal.Data sourcesMEDLINE/PubMed, Scopus, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trial were searched in September 2022, without any time restriction, for systematic reviews, narrative reviews, original articles. Results were summarised through narrative synthesis, tables, 95% CI.Outcome measuresMechanisms underlying placebo/nocebo effects and/or their effect sizes.ResultsThe databases search identified 372 studies, for a total of 158 312 participants, comprising 41 systematic reviews, 312 narrative reviews and 19 original articles. Seventy-three per cent of the examined systematic reviews were of high quality.Our findings revealed that mechanisms underlying placebo and/or nocebo effects have been characterised, at least in part, for: pain, non-noxious somatic sensation, Parkinson’s disease, migraine, sleep disorders, intellectual disability, depression, anxiety, dementia, addiction, gynaecological disorders, attention-deficit hyperactivity disorder, immune and endocrine systems, cardiovascular and respiratory systems, gastrointestinal disorders, skin diseases, influenza and related vaccines, oncology, obesity, physical and cognitive performance. Their magnitude ranged from 0.08 to 2.01 (95% CI 0.37 to 0.89) for placebo effects and from 0.32 to 0.90 (95% CI 0.24 to 1.00) for nocebo effects.ConclusionsThis study provides a valuable tool for clinicians and researchers, identifying both results ready for clinical practice and gaps to address in the near future.FundingUniversità Cattolica del Sacro Cuore, Milan, Italy with the ‘Finanziamento Ponte 2022’ grant.PROSPERO registration numberCRD42023392281.

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Section: Resultsmentioning

confidence: 99%

Section: Continuedmentioning

confidence: 99%

Placebo and nocebo effects and mechanisms associated with pharmacological interventions: an umbrella review

Frisaldi,

Shaibani,

Benedetti

et al. 2023

BMJ Open

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“…Dyspnoea is a symptom but it is also an experience that changes the brain of those afflicted (through memory/ anticipation phenomena, see refs. [5][6][7] ) and therefore shapes their lives. 8,9 This is particularly true when dyspnoea continues despite maximal pathophysiological treatments (persistent dyspnoea).…”

Section: Introductionmentioning

confidence: 99%

‘You can’t feel what we feel’: Multifaceted dyspnoea invisibility in advanced chronic obstructive pulmonary disease examined through interpretative phenomenological analysis

et al. 2022

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Background: More than a symptom, dyspnoea is an existential experience shaping the lives of those afflicted, particularly when its persistence despite maximal pathophysiological treatments makes it pervasive. It is, however, insufficiently appreciated by concerned people themselves, family members, healthcare professionals and the public (dyspnoea invisibility), limiting access to appropriate care and support. Aim: To provide a better understanding of dyspnoea experiences and its invisibility. Design: Interpretative phenomenological analysis of data collected prospectively through in-depth semi-structured interviews. Setting/Participants: Pulmonary rehabilitation facility of a tertiary care university hospital; 11 people (six men, five women) with severe chronic obstructive pulmonary disease (stages 3 and 4 of the 4-stage international GOLD classification) admitted for immediate post-exacerbation rehabilitation. Results: We identified several types of dyspnoea invisibility depending on temporality and interlocutors: (1) invisibility as a symptom to oneself; (2) invisibility as a symptom to others; (3) invisibility as an experience that cannot be shared; (4) invisibility as an experience detached from objective measurements; (5) invisibility as an experience that does not generate empathic concern. The notion of invisibility was present in all the identified experiential dimensions of dyspnoea. It was seen as worsening the burden of the disease and as self-aggravating through self-isolation and self-censorship. Conclusions: The study confirmed that dyspnoea invisibility is a reality for people with advanced chronic obstructive pulmonary disease. It shows dyspnoea invisibility to be a multifaceted burden. Future research should aim at identifying individual and collective measures to overcome dyspnoea invisibility.

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“…Instead, several variables including pain expectations can partially explain the relationship between unpredictability and pain perception (62-64). Such effects have not yet been systematically confirmed for breathlessness, although research has already repeatedly suggested comparable influences of expectations on breathlessness perception in both clinical and non-clinical samples (22,(65)(66)(67)(68)(69)(70). Negative expectations are also an important element of catastrophizing, itself associated with worse quality of life (71).…”

Section: Implication For Future Research and Clinical Practicementioning

confidence: 99%

The effect of unpredictability on the perception of breathlessness: a narrative review

Pavy,

Torta,

von Leupoldt

2024

Front. Rehabil. Sci.

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Breathlessness is an aversive bodily sensation impacting millions of people worldwide. It is often highly detrimental for patients and can lead to profound distress and suffering. Notably, unpredictable breathlessness episodes are often reported as being more severe and unpleasant than predictable episodes, but the underlying reasons have not yet been firmly established in experimental studies. This review aimed to summarize the available empirical evidence about the perception of unpredictable breathlessness in the adult population. Specifically, we examined: (1) effects of unpredictable relative to predictable episodes of breathlessness on their perceived intensity and unpleasantness, (2) potentially associated neural and psychophysiological correlates, (3) potentially related factors such as state and trait negative affectivity. Nine studies were identified and integrated in this review, all of them conducted in healthy adult participants. The main finding across studies suggested that unpredictable compared to predictable, breathlessness elicits more frequently states of high fear and distress, which may contribute to amplify the perception of unpredictable breathlessness, especially its unpleasantness. Trait negative affectivity did not seem to directly affect the perception of unpredictable breathlessness. However, it seemed to reinforce state fear and anxiety, hence possible indirect modulatory pathways through these affective states. Studies investigating neural correlates of breathlessness perception and psychophysiological measures did not show clear associations with unpredictability. We discuss the implication of these results for future research and clinical applications, which necessitate further investigations, especially in clinical samples suffering from breathlessness.

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Harnessing the power of anticipation to manage respiratory-related brain suffering and ensuing dyspnoea: insights from the neurobiology of the respiratory nocebo effect

Cited by 7 publications

References 73 publications

Placebo and nocebo effects and mechanisms associated with pharmacological interventions: an umbrella review

Placebo and nocebo effects and mechanisms associated with pharmacological interventions: an umbrella review

‘You can’t feel what we feel’: Multifaceted dyspnoea invisibility in advanced chronic obstructive pulmonary disease examined through interpretative phenomenological analysis

The effect of unpredictability on the perception of breathlessness: a narrative review

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