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(Chest. 2005;128:345-354.)
© 2005 American College of Chest Physicians

Cortical Substrates for the Perception of Dyspnea*

Andreas von Leupoldt, PhD and Bernhard Dahme, PhD

* From the Psychological Institute III, University of Hamburg, Hamburg, Germany.

Correspondence to: Andreas von Leupoldt, PhD, Psycho- logical Institute III, University of Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany; e-mail: andreas.vonleupoldt{at}uni-hamburg.de

Dyspnea is a common, unpleasant, and impairing symptom in various respiratory diseases and other diseases. Despite growing understanding of the multiple peripheral mechanisms giving rise to dyspnea, little is known about the cortical mechanisms underlying its perception. The results of neuroimaging studies have shown that distinct brain areas process the dyspneic sensation, among which the anterior insular seems to be the most important. Based on the findings of the first relevant neuroimaging studies, this review describes the cortical structures associated with the perception of dyspnea. Moreover, similarities to the perception of pain are discussed, and implications for future research are provided.

Key Words: asthma • brain • breathlessness • COPD • dyspnea • emission-CT • MRI • pain • perception




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