Dyspnoea is not a prominent complaint of resting patients with recent hemispheric stroke (RHS). We hypothesized that, in patients with RHS presenting abnormalities in respiratory mechanics, increased respiratory motor output could translate into an increased perception of dyspnoea. We studied eight wheelchair-bound patients with RHS (mean age 62.4 years), previously evaluated by computerized tomography scanning, and a control group of normal subjects, matched for age and sex. We assessed routine spirometry, inspiratory and expiratory muscle pressures, breathing pattern and dyspnoea using a modified Borg scale. In six patients, we also measured oesophageal pressure during the maximal sniff manoeuvre and tidal inspiratory swing, and mechanical characteristics of the lung in terms of dynamic elastance during both quiet breathing and a hypercapnic/hyperoxic rebreathing test. During room air breathing, ventilation and tidal volume were similar in patients and controls, while tidal inspiratory swings of oesophageal pressure, an index of inspiratory motor output, were greater in patients (P = 0.005). Patients also exhibited a greater dynamic elastance (P = 0.013). During rebreathing, dynamic elastance remained higher (P = 0.01) and a greater than normal inspiratory motor output was found (P = 0.03). Responses of ventilation and tidal volume to carbon dioxide tension were normal, and in all patients but one a lower Borg score for the unit change in carbon dioxide tension and ventilation was found. In conclusion, a higher than normal inspiratory motor output was unexpectedly associated with a blunted perception of dyspnoea in this subset of RHS patients. This is likely to be due to the modulation of the integration process of respiratory sensation.
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Research Article|
October 03 2002
Dissociation between respiratory effort and dyspnoea in a subset of patients with stroke
Barbara LANINI;
Barbara LANINI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Francesco GIGLIOTTI;
Francesco GIGLIOTTI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Claudia COLI;
Claudia COLI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Roberto BIANCHI;
Roberto BIANCHI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Assunta PIZZI;
Assunta PIZZI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Isabella ROMAGNOLI;
Isabella ROMAGNOLI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Michela GRAZZINI;
Michela GRAZZINI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Loredana STENDARDI;
Loredana STENDARDI
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
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Giorgio SCANO
1Fondazione Don C. Gnocchi, Department of Respiratory Disease, Via Imprunetana 124, 50020 Pozzolatico, Firenze, Italy
Correspondence: Dr Giorgio Scano (e-mail g.scano@dmi.unifi.it).
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Clin Sci (Lond) (2002) 103 (5): 467–473.
Article history
Received:
April 05 2002
Revision Received:
June 10 2002
Accepted:
July 12 2002
Citation
Barbara LANINI, Francesco GIGLIOTTI, Claudia COLI, Roberto BIANCHI, Assunta PIZZI, Isabella ROMAGNOLI, Michela GRAZZINI, Loredana STENDARDI, Giorgio SCANO; Dissociation between respiratory effort and dyspnoea in a subset of patients with stroke. Clin Sci (Lond) 1 November 2002; 103 (5): 467–473. doi: https://doi.org/10.1042/cs1030467
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