Dissociating breathlessness symptoms from mood in asthma

Harrison, Olivia K.; Marlow, Lucy; Finnegan, Sarah; Ainsworth, Ben; Pattinson, Kyle T.S.

doi:10.1101/2020.07.15.204289

Cited by 5 publications

(14 citation statements)

References 45 publications

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“…In an investigation of breathlessness in COPD we identified the most separable factors to be what a person felt they could or could not do, how their symptoms impacted their lives and their general mood [16]. Two of these factors, corresponding to mood and symptom burden, were identified in a second investigation conducted in individuals with asthma [15]. In this current work, mood/affect and symptom burden were again important factors, but here we were able to separate symptom burden into two factors; one focused on body burden (Factor 1) and a second factor relating to breathing burden (Factor 3).…”

Section: Discussionmentioning

confidence: 99%

“…Similar approaches have already been used to identify baseline factors, which together predict treatment response in depression [11, 12] and pain [13, 14]. Our previous work has drawn upon machine learning techniques in order to search for common features both across assessment tools and across the individuals who complete them [15-17]. The separable factors revealed by this work centre around mood/affect measures [15-17] and symptom burden measures [15, 16], with further important factors including anticipated and physical capability measures [16].…”

Section: Introductionmentioning

confidence: 99%

“…Our previous work has drawn upon machine learning techniques in order to search for common features both across assessment tools and across the individuals who complete them [15-17]. The separable factors revealed by this work centre around mood/affect measures [15-17] and symptom burden measures [15, 16], with further important factors including anticipated and physical capability measures [16]. Other independent studies using machine learning techniques to identify symptom-based phenotypes in asthma [18] and COPD [19, 20] also identified clusters of patients for whom breathlessness was linked with underlying mood/affect.…”

Section: Introductionmentioning

confidence: 99%

“…While our previous work has focused on identifying factors underling breathlessness within a single disease [16] or between a patient and a control group [15, 17], we have yet to determine whether a common model for the breathlessness experience can be identified across different cardiorespiratory diseases. Also, the stability of such models over time is unknown.…”

Section: Introductionmentioning

confidence: 99%

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A common model for the breathlessness experience

Finnegan

Pattinson

Sundh

et al. 2020

Preprint

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Introduction: Chronic breathlessness occurs across many different diseases, independently of severity. Yet, despite being strongly linked to adverse outcomes, chronic breathlessness is generally not considered a stand-alone treatment target. Here we move focus from identifying the "best" measurement tool and use data-driven techniques to identify and confirm the stability of underlying features (factors) driving breathlessness across different cardiorespiratory diseases. Such frameworks could provide an opportunity to address the underlying mechanisms of breathlessness and over-come issues with co-morbidities, particularly when medical therapies have been optimised. Methods: Longitudinal study of questionnaire data on 182 participants with main diagnoses of asthma (21.4%), COPD (24.7%), heart failure (19.2%), idiopathic pulmonary fibrosis (18.7%), other interstitial lung disease (5.5%), and "other diagnoses" (8.8%) were entered into an exploratory factor analysis (EFA). Participants were stratified based on their EFA factor scores, allowing us to examine whether the breathlessness experience differed across disease diagnosis. We then examined model stability after six months and established through an iterative process the most compact, and therefore least burdensome assessment tool. Results: From the 25 input measures, 16 measures were retained for model validation. The resulting model contained four factors to which we assigned the following descriptive labels: 1) body burden, 2) affect/mood, 3) breathing burden and 4) anger/frustration. Stratifying patients by their scores across the four factors revealed two groups corresponding to high and low burden. These were not found to be predictive of primary disease diagnosis and did remain stable after six months. Conclusions: We have identified four stable and disease-independent factors that seem to underlie the experience of breathlessness. We suggest that interventions may target factors within this framework to answer the question of whether they are also driving the experience itself.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A common model for the breathlessness experience

Finnegan

Pattinson

Sundh

et al. 2020

Preprint

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“…However, this work focused on identifying factors underling breathlessness within a single disease [21] or between a patient and a control group [20,22]. The aim of the present study was to address some outstanding questions:…”

Section: Introductionmentioning

confidence: 99%

A common model for the breathlessness experience across cardiorespiratory disease

et al. 2021

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IntroductionChronic breathlessness occurs across many different conditions, often independently of disease severity. Yet, despite being strongly linked to adverse outcomes, the consideration of chronic breathlessness as a stand-alone therapeutic target remains limited. Here we use data-driven techniques to identify and confirm the stability of underlying features (factors) driving breathlessness across different cardiorespiratory diseases.MethodsStudy of questionnaire data on 182 participants with main diagnoses of asthma (21.4%), COPD (24.7%), heart failure (19.2%), idiopathic pulmonary fibrosis (18.7%), other interstitial lung disease (5.5%), and “other diagnoses” (8.8%) were entered into an exploratory factor analysis (EFA). Participants were stratified based on their EFA factor scores. We then examined model stability using six-month follow-up data and established the most compact set of measures describing the breathlessness experience.ResultsIn this dataset, we have identified four stable factors that underlie the experience of breathlessness. These factors were assigned the following descriptive labels: 1) body burden, 2) affect/mood, 3) breathing burden and 4) anger/frustration. Stratifying patients by their scores across the four factors revealed two groups corresponding to high and low burden. These two groups were not related to the primary disease diagnosis and remained stable after six months.DiscussionIn this work we identified and confirmed the stability of underlying features of breathlessness. Previous work in this domain has been largely limited to single-diagnosis patient groups without subsequent re-testing of model stability. This work provides further evidence supporting disease independent approaches to assess breathlessness.

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Baseline psychological traits contribute to Lake Louise Acute Mountain Sickness score at high altitude

Talks

Campbell

Larcombe

et al. 2021

Preprint

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Background: Interoception refers to an individuals ability to sense their internal bodily sensations. Acute mountain sickness (AMS) is a common feature of ascent to high altitude that is only partially explained by measures of peripheral physiology. We hypothesised that interoceptive ability may explain the disconnect between measures of physiology and symptom experience in AMS. Methods and Material: Two groups of 18 participants were recruited to complete a respiratory interoceptive task three times at two-week intervals. The control group remained in Birmingham (140m altitude) for all three tests. The altitude group completed test 1 in Birmingham, test 2 the day after arrival at 2624m, and test 3 at 2728m after an 11-day trek at high altitude (up to 4800m). Results: By measuring changes to metacognitive performance, we showed that acute ascent to altitude neither presented an interoceptive challenge, nor acted as interoceptive training. However, AMS symptom burden throughout the trek was found to relate to sea-level measures of anxiety, agoraphobia, and neuroticism. Conclusions: This suggests that the Lake Louise AMS score is not solely a reflection of physiological changes on ascent to high altitude, despite often being used as such by researchers and commercial trekking companies alike.

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Dissociating breathlessness symptoms from mood in asthma

Cited by 5 publications

References 45 publications

A common model for the breathlessness experience

A common model for the breathlessness experience

A common model for the breathlessness experience across cardiorespiratory disease

Baseline psychological traits contribute to Lake Louise Acute Mountain Sickness score at high altitude

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