The biological impact of living with chronic breathlessness - A role for the hypothalamic-pituitary-adrenal axis?

Medical Hypotheses

Volumn 83, Issue 2, 2014, Pages 232-237

  Ryan, R ^a   Spathis, A ^a   Clow, A ^a   Fallon, M ^a   Booth, S ^a  

^a CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANXIETY; ANXIETY DISORDER; ARTICLE; DISEASE ASSOCIATION; DYSPNEA; FEAR; GENERALIZED ANXIETY DISORDER; HUMAN; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; LIMBIC SYSTEM; NEUROPSYCHOLOGY; PANIC; PREDICTOR VARIABLE; PROGNOSIS; STRESS; SURVIVAL; SURVIVAL PREDICTION; BIOLOGICAL MODEL; ETIOLOGY; HYPOPHYSIS ADRENAL SYSTEM; HYPOTHALAMUS HYPOPHYSIS SYSTEM; MENTAL STRESS; PATHOPHYSIOLOGY; PHYSIOLOGICAL STRESS; PHYSIOLOGY;

ANXIETY; DYSPNEA; HUMANS; HYPOTHALAMO-HYPOPHYSEAL SYSTEM; LIMBIC SYSTEM; MODELS, BIOLOGICAL; PITUITARY-ADRENAL SYSTEM; STRESS, PHYSIOLOGICAL; STRESS, PSYCHOLOGICAL;

EID: 84902788525     PISSN: 03069877     EISSN: 15322777     Source Type: Journal    
DOI: 10.1016/j.mehy.2014.04.011     Document Type: Article

References (68)

1. Gardiner C., Gott M., Small N., Payne S., Seamark D., Barnes S., et al. Living with advanced chronic obstructive pulmonary disease: patients concerns regarding death and dying. Palliat Med 2009, 23:691-697.
2. Seamark D.A., Blake S.D., Seamark C.J., Halpin D.M. Living with severe chronic obstructive pulmonary disease (COPD): perceptions of patients and their carers: an interpretative phenomenological analysis. Palliat Med 2004, 18:619-625.
3. Booth S., Silvester S., Todd C. Breathlessness in cancer and chronic obstructive pulmonary disease: using a qualitative approach to describe the experience of patients and carers. Palliat Support Care 2003, 1:337-344.
4. Gysels M.H., Higginson I.J. The lived experience of breathlessness and its implications for care: a qualitative comparison in cancer, COPD, heart failure and MND. BMC Palliat Care [Online] 2011, 10:15. Available from: [Accessed 27th Nov 2013].
5. Fries E., Hesse J., Hellhammer J., Hellhammer D.H. A new view on hypocortisolism. Psychoneuroendocrinology 2005, 30:1010-1016.
6. Clow A. Cortisol as a biomarker of stress. J Holistic Healthcare 2004, 1:10-14.
7. De Kloet E.R. Hormones and the stressed brain. Ann N Y Acad Sci 2004, 1018:1-15.
8. McEwen B.S. The neurobiology of stress: from serendipity to clinical relevance. Brain Res 2000, 886:172-189.
9. de Kloet E.R., Joels M., Holsboer F. Stress and the brain: from adaptation to disease. Nat Rev Neurosci 2005, 6:463-475.
10. Kumari M., Shipley M., Stafford M., Kivimaki M. Association of diurnal patterns in salivary cortisol with all-cause and cardiovascular mortality: findings from the Whitehall II study. J Clin Endocrinol Metab 2011, 96:1478-1485.
11. Sephton S.E., Sapolsky R.M., Kraemer H.C., Spiegel D. Diurnal cortisol rhythm as a predictor of breast cancer survival. J Natl Cancer Inst 2000, 92:994-1000.
12. Sephton S.E., Lush E., Dedert E.A., Floyd A.R., Rebholz W.N., Dhabhar F.S., et al. Diurnal cortisol rhythm as a predictor of lung cancer survival. Brain Behav Immun 2013, 30(SUPPL):S163-S170.
13. Abelson J.L., Khan S., Giardino N., Abelson J.L., Khan S., Giardino N. HPA axis, respiration and the airways in stress-a review in search of intersections. Biol Psychol 2010, 84:57-65.
14. Yellowlees P.M., Alpers J.H., Bowden J.J., Bryant G.D., Ruffin R.E. Psychiatric morbidity in patients with chronic airflow obstruction. Med J Aust 1987, 146:305-307.
15. Aghanwa H.S., Erhabor G.E. Specific psychiatric morbidity among patients with chronic obstructive pulmonary disease in a Nigerian general hospital. J Psychosom Res 2001, 50:179-183.
16. Aydin I.O., Ulusahin A. Depression, anxiety comorbidity, and disability in tuberculosis and chronic obstructive pulmonary disease patients: applicability of GHQ-12. Gen Hosp Psychiatry 2001, 23:77-83.
17. Brenes G.A. Anxiety and chronic obstructive pulmonary disease: prevalence, impact, and treatment. Psychosom Med 2003, 65:963-970.
18. Wittchen H.U., Zhao S., Kessler R.C., Eaton W.W. DSM-III-R generalized anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1994, 51:355-364.
19. Karajgi B., Rifkin A., Doddi S., Kolli R. The prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease. Am J Psychiatry 1990, 147:200-201.
20. Moore M.C., Zebb B.J. The catastrophic misinterpretation of physiological distress. Behav Res Ther 1999, 37:1105-1118.
21. Robins L.N., Helzer J.E., Weissman M.M. Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 1984, 41:949-958.
22. Borge C.R., Wahl A.K., Moum T. Association of breathlessness with multiple symptoms in chronic obstructive pulmonary disease. J Adv Nurs 2010, 66:2688-2700.
23. Zandbergen J., Bright M., Pols H., Fernandez I., De Loof C., Griez E.J.L. Higher lifetime prevalence of respiratory diseases in panic disorder?. Am J Psychiatry 1991, 148:1583-1585.
24. Abelson J.L., Weg J.G., Nesse R.M., Curtis G.C. Persistent respiratory irregularity in patients with panic disorder. Biol Psychiatry 2001, 49:588-595.
25. Lansing R.W., Gracely R.H., Banzett R.B. The multiple dimensions of dyspnea: review and hypotheses. Respir Physiol Neurobiol 2009, 167:53-60.
26. Von Leupoldt A., Dahme B. Differentiation between the sensory and affective dimension of dyspnea during resistive load breathing in normal subjects. Chest 2005, 128:3345-3349.
27. Williams M., Cafarella P., Olds T., Petkov J., Frith P. Affective descriptors of the sensation of breathlessness are more highly associated with severity of impairment than physical descriptors in people with COPD. Chest 2010, 138:315-322.
28. Bailey P.H. The dyspnea-anxiety-dyspnea cycle - COPD patients' stories of breathlessness: "It's scary /when you can't breathe". Qual Health Res 2004, 14:760-778.
29. von Leupoldt A., Taube K., Henkhus M., Dahme B., Magnussen H. The impact of affective states on the perception of dyspnea in patients with chronic obstructive pulmonary disease. Biol Psychol 2010, 84:129-134.
30. von Leupoldt A., Seemann N., Gugleva T., Dahme B. Attentional distraction reduces the affective but not the sensory dimension of perceived dyspnea. Respir Med 2007, 101:839-844.
31. Von Leupoldt A., Taube K., Schubert-Heukeshoven S., Magnussen H., Dahme B. Distractive auditory stimuli reduce the unpleasantness of dyspnea during exercise in patients with COPD. Chest 2007, 132:1506-1512.
32. Vreeburg S.A., Zitman F.G., Van Pelt J., Derijk R.H., Verhagen J.C.M., Van Dyck R., et al. Salivary cortisol levels in persons with and without different anxiety disorders. Psychosom Med 2010, 72:340-347.
33. Hek K., Direk N., Newson R.S., Hofman A., Hoogendijk W.J.G., Mulder C.L., et al. Anxiety disorders and salivary cortisol levels in older adults: a population-based study. Psychoneuroendocrinology 2013, 38:300-305.
34. Vreeburg S.A., Hoogendijk W.J.G., DeRijk R.H., van Dyck R., Smit J.H., van Dyck R., Zitman F.G., Penninx B.W.J.H. Salivary cortisol levels and the 2-year course of depressive and anxiety disorders. Psychoneuroendocrinology 2013, 38:1494-1502.
35. Herigstad M., Hayen A., Wiech K., Pattinson K.T.S. Dyspnoea and the brain. Respir Med 2011, 105:809-817.
36. von Leupoldt A., Sommer T., Kegat S., Baumann H.J., Klose H., Dahme B., et al. Dyspnea and pain share emotion-related brain network. Neuroimage 2009, 48:200-206.
37. Tataranni P.A., Gautier J.F., Chen K., Uecker A., Bandy D., Salbe A.D., et al. Neuroanatomical correlates of hunger and satiation in humans using positron emission tomography. Proc Natl Acad Sci U S A 1999, 96:4569-4574.
38. Farrell M.J., Egan G.F., Zamarripa F., Shade R., Blair-West J., Fox P., et al. Unique, common, and interacting cortical correlates of thirst and pain. Proc Natl Acad Sci U S A 2006, 103:2416-2421.
39. Davenport P.W., Vovk A. Cortical and subcortical central neural pathways in respiratory sensations. Respir Physiol Neurobiol 2009, 167:72-86.
40. Von Leupoldt A., Dahme B. Cortical substrates for the perception of dyspnea. Chest 2005, 128:345-354.
41. Chan P.Y., Davenport P.W., Chan P.-Y.S., Davenport P.W. Respiratory-related-evoked potential measures of respiratory sensory gating in attend and ignore conditions. J Clin Neurophysiol 2009, 26:438-445.
42. Pruessner J.C., Baldwin M.W., Dedovic K., Renwick R., Mahani N.K., Lord C., et al. Self-esteem, locus of control, hippocampal volume, and cortisol regulation in young and old adulthood. Neuroimage 2005, 28:815-826.
43. Pruessner J.C., Dedovic K., Khalili-Mahani N., Engert V., Pruessner M., Buss C., et al. Deactivation of the limbic system during acute psychosocial stress: evidence from positron emission tomography and functional magnetic resonance imaging studies. Biol Psychiatry 2008, 63:234-240.
44. Wang J., Rao H., Wetmore G.S., Furlan P.M., Korczykowski M., Dinges D.F., et al. Perfusion functional MRI reveals cerebral blood flow pattern under psychological stress. Proc Natl Acad Sci U S A 2005, 102:17804-17809.
45. Kern S., Oakes T.R., Stone C.K., McAuliff E.M., Kirschbaum C., Davidson R.J. Glucose metabolic changes in the prefrontal cortex are associated with HPA axis response to a psychosocial stressor. Psychoneuroendocrinology 2008, 33:517-529.
46. Cunningham-Bussel A.C., Root J.C., Butler T., Tuescher O., Pan H., Epstein J., et al. Diurnal cortisol amplitude and fronto-limbic activity in response to stressful stimuli. Psychoneuroendocrinology 2009, 34:694-704.
47. Dedovic K., Duchesne A., Andrews J., Engert V., Pruessner J.C. The brain and the stress axis: The neural correlates of cortisol regulation in response to stress. Neuroimage 2009, 47:864-871.
48. Veer I.M., Oei N.Y.L., Spinhoven P., Van Buchem M.A., Elzinga B.M., Rombouts S.A.R.B. Endogenous cortisol is associated with functional connectivity between the amygdala and medial prefrontal cortex. Psychoneuroendocrinology 2012, 37:1039-1047.
49. Kiem S.A., Andrade K.C., Spoormaker V.I., Holsboer F., Czisch M., Samann P.G. Resting state functional MRI connectivity predicts hypothalamus-pituitary-axis status in healthy males. Psychoneuroendocrinology 2013, 38:1338-1348.
50. Jankord R., Herman J.P. Limbic regulation of hypothalamo-pituitary-adrenocortical function during acute and chronic stress. Ann N Y Acad Sci 2008, 64-73.
51. Gallagher B.B., Flanigin H.F., King D.W., Littleton W.H. The effect of electrical stimulation of medial temporal lobe structures in epileptic patients upon ACTH, prolactin, and growth hormone. Neurology 1987, 37:299-303.
52. Parshall M.B., Schwartzstein R.M., Adams L., Banzett R.B., Manning H.L., Bourbeau J., et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med 2012, 185:435-452.
53. Nishimura K., Izumi T., Tsukino M., Oga T., Nishimura K., Izumi T., et al. Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD. Chest 2002, 121:1434-1440.
54. Nishiyama O., Taniguchi H., Kondoh Y., Kimura T., Kato K., Kataoka K., et al. A simple assessment of dyspnoea as a prognostic indicator in idiopathic pulmonary fibrosis. Eur Respir J 2010, 36:1067-1072.
55. Pocock S.J., Wang D., Pfeffer M.A., Yusuf S., McMurray J.J.V., Swedberg K.B., et al. Predictors of mortality and morbidity in patients with chronic heart failure. Eur Heart J 2006, 27:65-75.
56. Herndon I.J.E., Fleishman S., Kornblith A.B., Kosty M., Green M.R., Holland J. Is quality of life predictive of the survival of patients with advanced nonsmall cell lung carcinoma?. Cancer 1999, 85:333-340.
57. Maltoni M., Caraceni A., Brunelli C., Broeckaert B., Christakis N., Eychmueller S., et al. Prognostic factors in advanced cancer patients: evidence-based clinical recommendations-a study by the Steering Committee of the European Association for Palliative Care. J Clin Oncol 2005, 23:6240-6248.
58. Mahler D.A., Weinberg D.H., Wells C.K., Feinstein A.R. The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest 1984, 85:751-758.
59. Meek P.M.S.R., Adams L., Altose M.D., Breslin E.H., Carrieri-Kohlman V., et al. Dyspnea: mechanisms, assessment, and management: A consensus statement. Am J Respir Crit Care Med 1999, 159:321-340.
60. Cohen L., Cole S.W., Sood A.K., Prinsloo S., Kirschbaum C., Arevalo J.M.G., et al. Depressive symptoms and cortisol rhythmicity predict survival in patients with renal cell carcinoma: Role of inflammatory signaling. PLoS ONE 2012, 7(8):e42324. [Available at: Nov 2013, 10.1371/journal.pone.0042324 [Accessed 28th]].
61. Eismann E.A., Lush E., Sephton S.E. Circadian effects in cancer-relevant psychoneuroendocrine and immune pathways. Psychoneuroendocrinology 2010, 35:963-976.
62. Filipski E., King V.M., Li X., Granda T.G., Mormont M.C., Liu X., et al. Host circadian clock as a control point in tumor progression. J Natl Cancer Inst 2002, 94:690-697.
63. Mormont M.C., Levi F. Circadian-system alterations during cancer processes: a review. Int J Cancer 1997, 70:241-247.
64. Spiegel D., Bloom J., Kraemer H., Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 1989, 2:888-891.
65. Andersen B.L., Yang H.C., Farrar W.B., Golden-Kreutz D.M., Emery C.F., Thornton L.M., et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer 2008, 113:3450-3458.
66. Fawzy F.I., Fawzy N.W., Hyun C.S., Elashoff R., Guthrie D., Fahey J.L., et al. Malignant melanoma. Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Arch Gen Psychiatry 1993, 50:681-689.
67. Antoni M.H. Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer. Brain Behav Immun 2013, 30(Suppl):S88-S98.
68. Volden P.A., Conzen S.D. The influence of glucocorticoid signaling on tumor progression. Brain Behav Immun 2013, 30(Suppl):S26-S31.