Interactions Between Dyspnea and the Brain Processing of Nociceptive Stimuli: Experimental Air Hunger Attenuates Laser-Evoked Brain Potentials in Humans

Dangers, Laurence; Laviolette, Louis; Similowski, Thomas; Morélot-Panzini, Capucine

doi:10.3389/fphys.2015.00358

Cited by 11 publications

(8 citation statements)

References 63 publications

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“…In settings of heightened breathlessness, the MDP was more commonly used than the D-12 (14 of 37 datasets versus D-12 1 of 33 datasets), where breathlessness was induced in the laboratory [6,52,59,60,65,66,68,72,73,76,79,84], or a specific threshold for breathlessness (e.g., ≥ 4/10 on MDP-A1) was required for participant inclusion in clinical studies (D-12 [34]; MDP [52,53]) (Supplemental Materials Table S3A and B).…”

Section: Reporting Of Scores/ratingsmentioning

confidence: 99%

Dyspnoea-12 and Multidimensional Dyspnea Profile: Systematic Review of Use and Properties

Williams

Lewthwaite

Paquet

et al. 2022

Journal of Pain and Symptom Management

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Reporting Of Scores/ratingsmentioning

confidence: 99%

Dyspnoea-12 and Multidimensional Dyspnea Profile: Systematic Review of Use and Properties

Williams

Lewthwaite

Paquet

et al. 2022

Journal of Pain and Symptom Management

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“…The interoreceptive pathway then rises toward higher centers, passing through the medial thalamic nuclei. The thalamus may act as a gate that blocks some ascending signals related to respiration giving priority to other inputs (64), but there is no functional evidence that air hunger can be gated out -in fact, there is some evidence that air hunger can close the gate for pain sensation (60,61,234). Air hunger related activity in the human medial thalamus has been observed in two studies (18, 136).…”

Section: Air Hunger Activates Interoreceptive Pathway and Salience Ne...mentioning

confidence: 99%

Air Hunger: A Primal Sensation and a Primary Element of Dyspnea

Banzett

Lansing

Binks

2021

Comprehensive Physiology

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The sensation that develops as a long breath hold continues is what this chapter is about. We term this sensation of an urge to breathe "air hunger". Air hunger is a primal sensation that alerts us to a failure to meet an urgent homeostatic need -to maintain gas exchange. Anxiety, frustration, and fear evoked by air hunger motivate behavioral actions to address the failure. Air hunger can be reliably quantified by most experimental subjects using rating scales, i.e., there is a consistent relationship between stimulus and rating. Stimuli that increase air hunger include hypercapnia, hypoxia, exercise, and acidosis, while tidal expansion of the lungs reduces air hunger. As such, the defining experimental paradigm to evoke air hunger is to elevate the drive to breath while mechanically restricting ventilation. Functional brain imaging studies have shown that air hunger activates the insular cortex (an integration center for perceptions related to homeostasis, including pain, food hunger and thirst), as well as limbic structures involved with anxiety and fear. The unpleasantness and emotional consequences of air hunger make it the most debilitating component of dyspnea, a symptom commonly associated with respiratory, cardiovascular and metabolic diseases. Although much has been learned about air hunger in the past few decades, much remains to be discovered, such as an accepted method to quantify air hunger in non-human animals, fundamental questions about neural mechanisms, and adequate and safe methods to mitigate air hunger in clinical situations. DIDACTIC SYNOPSIS Air hunger is the conscious appreciation of an uncomfortable urge to breathe.  Air hunger can be reliably scaled by most people using various psychophysical rating scales.Although non-human vertebrates presumably sense air hunger, there is currently no accepted experimental model to scale air hunger in animals.  Air hunger is a primal sensation, alerting the animal to a threat to homeostasis that requires a behavioral response more complex than increasing respiratory muscle output or cardiac output.  Air hunger activates limbic and paralimbic regions in the brain giving rise to anxiety and fear.  Air hunger arises when minute ventilation is less than desired minute ventilation. Current understanding is that a copy of motor activity in medullary respiratory centers ('corollary discharge') projects to sensory cortex, and is compared to signals of tidal lung inflation arising mainly in pulmonary stretch receptors.  Air hunger is the most uncomfortable and most prominent of the sensations comprising clinical dyspnea.

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“…Dyspnoea is a threatening sensation that shares common neural networks and clinical features with pain [1,2]. In contrast with pain, which has received major attention in the intensive care unit (ICU) [3,4], little attention has been paid to dyspnoea [5].…”

Section: Introductionmentioning

confidence: 99%

Dyspnoea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact

et al. 2018

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Dyspnoea is a frequent and intense symptom in intubated patients, but little attention has been paid to dyspnoea during noninvasive mechanical ventilation in the intensive care unit (ICU).The objectives of this study were to quantify the prevalence, intensity and prognostic impact of dyspnoea in patients receiving noninvasive ventilation (NIV) for acute respiratory failure (ARF) based on secondary analysis of a prospective observational cohort study in patients who received ventilatory support for ARF in 54 ICUs in France and Belgium. Dyspnoea was measured by a modified Borg scale.Among the 426 patients included, the median (interquartile range) dyspnoea score was 4 (3-5) on admission and 3 (2-4) after the first NIV session (p=0.001). Dyspnoea intensity ≥4 after the first NIV session was associated with the Sequential Organ Failure Assessment Score (odds ratio (OR) 1.12, p=0.001), respiratory rate (OR 1.03, p=0.032), anxiety (OR 1.92, p=0.006), leaks (OR 2.5, p=0.002) and arterial carbon dioxide tension (OR 0.98, p=0.025). Dyspnoea intensity ≥4 was independently associated with NIV failure (OR 2.41, p=0.001) and mortality (OR 2.11, p=0.009), but not with higher post-ICU burden and altered quality of life.Dyspnoea is frequent and intense in patients receiving NIV for ARF and is associated with a higher risk of NIV failure and poorer outcome.

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Interactions Between Dyspnea and the Brain Processing of Nociceptive Stimuli: Experimental Air Hunger Attenuates Laser-Evoked Brain Potentials in Humans

Cited by 11 publications

References 63 publications

Dyspnoea-12 and Multidimensional Dyspnea Profile: Systematic Review of Use and Properties

Dyspnoea-12 and Multidimensional Dyspnea Profile: Systematic Review of Use and Properties

Air Hunger: A Primal Sensation and a Primary Element of Dyspnea

Dyspnoea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact

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