Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Understanding the Importance of Plasticity in the Brain Mechanisms of Dyspnoea Perception
Dyspnoea is the uncomfortable shortness of breath that debilitates millions of patients with
lung disease, heart failure and cancer. It is often very difficult to treat. The sensations
of dyspnoea are processed in the brain, and we believe that psychological factors modify and
amplify these sensations, frequently exacerbating symptoms.
This study aims to identify the importance of learning in the brain mechanisms of dyspnoea by
investigating a cohort of patients with chronic breathlessness undergoing pulmonary
rehabilitation . Pulmonary rehabilitation is a six-week course of exercise, education and
group therapy that improves dyspnoea but does not improve lung function. This leads us to
hypothesise that some of the beneficial effects of PR maybe due to changes in brain
processing, potentially relating to a learning effect.
Therefore to probe whether learning is important in the beneficial effects of pulmonary
rehabilitation, we intend to modify learning with the drug d-cycloserine. D-cycloserine is an
antibiotic that enhances learning due to its effects at N-methyl D-aspartate (NMDA) receptors
in the hippocampus. Our previous study in a similar group of patients demonstrated the
importance of the hippocampus in breathlessness perception, and we now wish to investigate
this in more depth.
The study involves collecting physiological, psychological and clinical measures on in
conjunction with brain scanning, before, during and once after pulmonary rehabilitation.
Subjects will either receive d-cyloserine or placebo before the first four pulmonary
rehabilitation sessions.
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