Treating breathlessness via the brain: Changes in brain activity over a course of pulmonary rehabilitation

HERIGSTAD, Mari, FAULL, O.K., HAYEN, A., EVANS, E., HARDINGE, F.M., WIECH, K. and PATTINSON, K.T.S. (2017). Treating breathlessness via the brain: Changes in brain activity over a course of pulmonary rehabilitation. European Respiratory Journal, 50 (3), p. 1701029.

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© ERS 2017. Breathlessness in chronic obstructive pulmonary disease (COPD) is often discordant with airway pathophysiology ("over-perception"). Pulmonary rehabilitation profoundly affects breathlessness, without influencing lung function. Learned associations influence brain mechanisms of sensory perception. We hypothesised that improvements in breathlessness with pulmonary rehabilitation may be explained by changing neural representations of learned associations. In 31 patients with COPD, we tested how pulmonary rehabilitation altered the relationship between brain activity during a breathlessness-related word-cue task (using functional magnetic resonance imaging), and clinical and psychological measures of breathlessness. Changes in ratings of breathlessness word cues positively correlated with changes in activity in the insula and anterior cingulate cortex. Changes in ratings of breathlessness-anxiety negatively correlated with activations in attention regulation and motor networks. Baseline activity in the insula, anterior cingulate cortex and prefrontal cortex correlated with improvements in breathlessness and breathlessness-anxiety. Pulmonary rehabilitation is associated with altered neural responses related to learned breathlessness associations, which can ultimately influence breathlessness perception. These findings highlight the importance of targeting learned associations within treatments for COPD, demonstrating how neuroimaging may contribute to patient stratification and more successful personalised therapy.

Item Type: Article
Uncontrolled Keywords: Aged; Anxiety; Behavior Rating Scale; Case-Control Studies; Cerebral Cortex; Dyspnea; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Self Report; Visual Analog Scale; Cerebral Cortex; Humans; Pulmonary Disease, Chronic Obstructive; Dyspnea; Magnetic Resonance Imaging; Case-Control Studies; Anxiety; Aged; Middle Aged; Female; Male; Self Report; Visual Analog Scale; Behavior Rating Scale; Respiratory System; 11 Medical and Health Sciences
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Page Range: p. 1701029
SWORD Depositor: Symplectic Elements
Depositing User: Symplectic Elements
Date Deposited: 07 Jan 2020 15:16
Last Modified: 18 Mar 2021 02:54

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