Dear Users

Today (4-5 pm YNiC open plan) Miriam Johnson from the Hull York Medical School will give a talk on "Magnetoencephalography appearances in breathless patients with and without air flow directed to the face."

Everyone is welcome to attend.

Best wishes Rebecca

Background: Intractable breathlessness is a common and devastating consequence of many diseases. Breathlessness affects all aspects of life, causing major distress for both patient and caregiver. Many patients face psychological, social and physical repercussions of persistent breathlessness, which require, long-term NHS support especially out of hours. Research into possible mechanisms for the perception of breathlessness has largely concentrated on peripheral pathways. However there is a growing interest in functional brain imaging using positron electron tomography scanning and functional MRI (fMRI), mainly in induced breathlessness in healthy volunteers. Similarities with pain perception are striking. However, little is known of these processes in patients with chronic breathlessness due to lung disease, indeed, one study suggests that patients with asthma demonstrate habituation and down-regulation of perceived unpleasantness due to breathlessness. Moreover we know nothing of the effect of interventions to improve breathlessness; patients with chronic breathlessness tolerate fMRI poorly. Magnetoencephalography (MEG) scanning is a possibly tolerated method but has not been tried. There is some clinical evidence that the use of a handheld fan reduces the sensation of breathlessness and may reduce the need for nebulisers and oxygen. The fan directs airflow to the area innervated by the 2nd and 3rd branches of the trigeminal nerve. It is universally available, cheap, non-invasive and easy to use in any setting alongside any other breathlessness intervention with no contra-indications. As the cost to the NHS of oxygen, nebulisers and inhalers and hospital admission are considerable, this area warrants research both with regard to clinical effect but also to mechanism of action.