Treating breathlessness via the brain: changes in brain activity over a course of pulmonary rehabilitation.
Treating breathlessness via the brain: changes in brain activity over a course of pulmonary rehabilitation.
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DOI：
10.1183/13993003.01029-2017
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Pattinson KTS
中科院分区：
文献类型：
--
作者：
Herigstad M;Faull OK;Hayen A;Evans E;Hardinge FM;Wiech K;Pattinson KTS
慢性阻塞性肺疾病（COPD）的呼吸困难通常与气道病理生理（“过度感知”）不一致。肺康复对呼吸困难有深刻影响，但不影响肺功能。习得联想影响感觉知觉的大脑机制。我们假设肺部康复后呼吸困难的改善可以通过改变习得关联的神经表征来解释。在31名COPD患者中，我们测试了肺部康复如何改变与呼吸困难相关的单词提示任务（使用功能性磁共振成像）期间大脑活动与呼吸困难的临床和心理测量之间的关系。呼吸困难单词提示等级的变化与脑岛和前扣带皮层活动的变化正相关。呼吸困难-焦虑评分的变化与注意力调节和运动网络的激活负相关。脑岛、前扣带皮层和前额叶皮层的基线活动与呼吸困难和呼吸困难焦虑的改善相关。肺部康复与习得性呼吸困难相关的神经反应改变有关，这最终会影响呼吸困难的感知。这些发现强调了在COPD治疗中靶向学习关联的重要性，证明了神经影像学如何有助于患者分层和更成功的个性化治疗。肺部康复通过重新校准大脑的感觉知觉网络http://ow.ly/crhy30cQerx来改善呼吸困难
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. Pulmonary rehabilitation improves breathlessness by recalibrating the brain's sensory perception networks http://ow.ly/crhy30cQerx
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DOI：
10.1038/nrn3950
发表时间：
2015-07
期刊：
Nature reviews. Neuroscience
影响因子：
--
作者：
Barrett LF;Simmons WK
通讯作者：
Simmons WK
影响因子：
2.3
作者：
Herigstad, Mari;Hayen, Anja;Pattinson, Kyle T. S.
通讯作者：
Pattinson, Kyle T. S.
影响因子：
9.6
作者：
Herigstad M;Hayen A;Evans E;Hardinge FM;Davies RJ;Wiech K;Pattinson KTS
通讯作者：
Pattinson KTS
医学研究委员会（MRC）呼吸困难量表作为慢性阻塞性肺病患者残疾度量标准的实用性
影响因子：
10
作者：
Bestall, JC;Paul, EA;Wedzicha, JA
通讯作者：
Wedzicha, JA
影响因子：
2
作者：
Carrieri-Kohlman, Virginia;Donesky-Cuenco, DorAnne;Paul, Steven M.
通讯作者：
Paul, Steven M.