The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Pathophysiology of Dyspnea in Chronic Obstructive Pulmonary Disease: A Roundtable
Abstract
Effective management of dyspnea in chronic obstructive pulmonary disease (COPD) requires a clearer understanding of its underlying mechanisms. This roundtable reviews what is currently known about the neurophysiology of dyspnea with the aim of applying this knowledge to the clinical setting. Dyspnea is not a single sensation, having multiple qualitative descriptors. Primary sources of dyspnea include: (1) inputs from multiple somatic proprioceptive and bronchopulmonary afferents, and (2) centrally generated signals related to inspiratory motor command output or effort. Respiratory disruption that causes a mismatch between medullary respiratory motor discharge and peripheral mechanosensor afferent feedback gives rise to a distressing urge to breathe which is independent of muscular effort. Recent brain imaging studies have shown increased limbic system activation in response to various dyspneogenic stimuli and emphasize the affective dimension of this symptom. All of these mechanisms are likely instrumental in exertional dyspnea causation in COPD. Increased central motor drive (and effort) is required to increase ventilation during activity because the inspiratory muscles become acutely overloaded and functionally weakened. Abnormal dynamic ventilatory mechanics and excessive chemostimulation during exercise also result in a widening disparity between escalating central neural drive and restricted thoracic volume displacement. This neuromechanical uncoupling may form the basis for the distressing sensation of unsatisfied inspiration. Interventions that alleviate dyspnea in COPD do so by improving ventilatory mechanics, reducing central neural drive, or both—thereby partially restoring neuromechanical coupling of the respiratory system. Self-management strategies address the affective aspect of dyspnea and are essential to successful treatment.
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Self-citationSelf-management approaches for people with chronic conditions: a review
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Neural adaptation to resistance training
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Dynamic Hyperinflation and Exercise Intolerance in Chronic Obstructive Pulmonary Disease
O'DONNELL, D. E., REVILL, S. M., & WEBB, K. A. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.164.5.2012122 · Cited by 1,076
Self-citationDyspnea: Mechanisms, Assessment, and Management: A Consensus Statement
(1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.1.ats898 · Cited by 1,052
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Self-citationO'DONNELL, D. E., LAM, M., & WEBB, K. A. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.160.2.9901038 · Cited by 485
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The multiple dimensions of dyspnea: Review and hypotheses
Lansing, R. W., Gracely, R. H., & Banzett, R. B. (2009) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2008.07.012 · Cited by 355
Self-citationThe Unpleasantness of Perceived Dyspnea Is Processed in the Anterior Insula and Amygdala
von Leupoldt, A., Sommer, T., Kegat, S., Baumann, H. J., Klose, H., Dahme, B., & Büchel, C. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200712-1821oc · Cited by 302
Martin, A. D., Smith, B. K., Davenport, P. D., Harman, E., Gonzalez-Rothi, R. J., Baz, M., Layon, A. J., Banner, M. J., Caruso, L. J., Deoghare, H., et al. (2011) · Critical Care · doi:10.1186/cc10081 · Cited by 294
Self-citationMarciniuk, D. D., Goodridge, D., Hernandez, P., Rocker, G., Balter, M., Bailey, P., Ford, G., Bourbeau, J., O’Donnell, D. E., Maltais, F., et al. (2011) · Canadian Respiratory Journal · doi:10.1155/2011/745047 · Cited by 264
Self-citationThe major limitation to exercise performance in COPD is dynamic hyperinflation
O'Donnell, D. E., & Webb, K. A. (2008) · Journal of Applied Physiology · doi:10.1152/japplphysiol.90336.2008b · Cited by 221
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Metadata
- Authors
- O'Donnell, D. E., Banzett, R. B., Carrieri-Kohlman, V., Casaburi, R., Davenport, P. W., Gandevia, S. C., Gelb, A. F., Mahler, D. A., & Webb, K. A.
- Venue
- Proceedings of the American Thoracic Society
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-05-01
- Volume
- 4
- Issue
- 2
- Pages
- 145-168
- ISSN
- 1546-3222 (ISSN-L)
- 1943-5665
- OpenAlex
- W2078577501
- Cited by
- 380
- References
- 23
- FWCI
- 20.05
- Type
- journal article
- Language
- en
- Open access
- closed
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- O'Donnell, D. E., Banzett, R. B., Carrieri-Kohlman, V., Casaburi, R., Davenport, P. W., Gandevia, S. C., Gelb, A. F., Mahler, D. A., & Webb, K. A. (2007). Pathophysiology of Dyspnea in Chronic Obstructive Pulmonary Disease: A Roundtable. Proceedings of the American Thoracic Society. https://doi.org/10.1513/pats.200611-159cc
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