TY - JOUR T1 - Opioids for breathlessness: psychological and neural factors influencing response variability JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00275-2019 VL - 54 IS - 3 SP - 1900275 AU - Sara J. Abdallah AU - Olivia K. Faull AU - Vishvarani Wanigasekera AU - Sarah L. Finnegan AU - Dennis Jensen AU - Kyle T.S. Pattinson Y1 - 2019/09/01 UR - http://erj.ersjournals.com/content/54/3/1900275.abstract N2 - Chronic breathlessness is a multidimensional and aversive symptom, which is often poorly explained by underlying pathophysiology [1]. For many sufferers, breathlessness is refractory to maximal medical therapies that target disease processes [2]. However, opioids are thought to be a possible therapeutic avenue to treat symptomology independently of disease [3]. Importantly, research in chronic pain has demonstrated that qualities such as anxiety and depression (collectively termed negative affect here) can both exacerbate symptoms [4] and reduce opioid efficacy [5, 6]. Therefore, it may be pertinent to consider such behavioural factors when contemplating the use of opioids for breathlessness.Diminished opioid efficacy in the treatment of breathlessness is related to negative affect and anticipatory brain activity in the anterior cingulate and medial prefrontal cortex. http://bit.ly/2LXyyDoThe authors wish to thank the contributions of Anja Hayen (P1vital, Oxford, UK), Mari Herigstad (Sheffield Hallam University, Sheffield, UK), and Stewart Campbell, Payashi Garry, Simon Raby, Josephine Robertson and Ruth Webster (all Oxford University Hospitals NHS Foundation Trust, Oxford, UK) towards the data collection for the healthy volunteer study. ER -