PT  - JOURNAL ARTICLE
AU  - Roland W. Esser
AU  - M. Cornelia Stoeckel
AU  - Anne Kirsten
AU  - Henrik Watz
AU  - Kirsten Lehmann
AU  - Karin Taube
AU  - Christian Büchel
AU  - Helgo Magnussen
AU  - Andreas Von Leupoldt
TI  - Neural correlates of dyspnea in COPD
AID  - 10.1183/13993003.congress-2015.OA4954
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - OA4954
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/OA4954.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/OA4954.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Patients with COPD suffer from chronic dyspnea. Previous studies on the neural mechanisms underlying dyspnea perception were investigated in healthy volunteers only. We tested whether COPD patients compared to healthy controls show different neural responses while anticipating and perceiving dyspnea, and whether neural responses correlate with disease-specific characteristics.Using functional magnetic resonance imaging, 17 stable outpatients with moderate-to-severe COPD were compared with 21 matched controls. Conditions of baseline and inspiratory resistive load-induced dyspnea were repeatedly presented for 24s in alternating order. Each trial was preceded by a 6s anticipation phase, being signalled by specific cues. After each trial subjects provided Borg ratings of perceived dyspnea unpleasantness and intensity.Patients and controls showed comparable ratings of dyspnea unpleasantness and intensity. During dyspnea perception, patients and controls showed comparable activations in sensorimotor and limbic brain regions with known relevance for dyspnea perception. For dyspnea anticipation, patients showed greater neural activation in fear-related brain areas, such as hippocampus and amygdala, when compared to controls. In patients, disease duration and symptom level were positively correlated with neural activity in the amygdala, anterior cingulate, and prefrontal cortex.The present findings suggest that chronic exposure to dyspnea in COPD patients affects mainly neural responses during the anticipation of dyspnea. Correlations between neural activity and disease-specific characteristics might be related to the development of dyspnea-related fear/anxiety, or mirror the neural effort for emotional regulation and control.