Development of a dyspnoea word cue set for studies of emotional processing in COPD

- The first cue-based task to explore recall of dyspnoea and dyspnoea-related anxiety in COPD.
- Patients' dyspnoea and dyspnoea-anxiety ratings agreed with established measures of dyspnoea.
- Patients' dyspnea-anxiety ratings changed in accordance with clinical improvement.
- The task was reliable and well tolerated.
- The task is suitable for FMRI use and may aid dyspnoea neuroimaging research.

Patients with chronic dyspnoea may learn to fear situations that cue dyspnoea onset. Such dyspnoea-specific cues may then cause anxiety, and worsen or trigger dyspnoea even before commencement of physical activity. We therefore developed an experimental tool to probe emotional processing of dyspnoea for use with neuroimaging in COPD. The tool consists of a computerised task comprising multiple presentations of dyspnoea-related word cues with subsequent rating of dyspnoea and dyspnoea-anxiety with a visual analogue scale. Following 3 development stages, sensitivity to clinical change was tested in 34 COPD patients undergoing pulmonary rehabilitation. We measured internal consistency, sensitivity to clinical change and convergence with established dyspnoea measures (including Dyspnoea-12). Cronbach's alpha was 0.90 for dyspnoea and 0.94 for dyspnea-anxiety ratings. Ratings correlated with Dyspnoea-12 (dyspnoea: r = 0.51, P = 0.002; dyspnea-anxiety: r = 0.54, P = 0.001). Reductions in dyspnea-anxiety ratings following pulmonary rehabilitation correlated with reductions in Dyspnoea-12 (r = 0.51, P = 0.002). We conclude that the word-cue task is reliable, and is thus a potentially useful tool for neuroimaging dyspnoea research.