Dyspnoea patterns in patients with advanced diseases : a functional MRI feasibility study protocol

Article Article scientifique Article Dyspnoea patterns in patients with advanced diseases : a functional MRI feasibility study protocol eng 2026-02-15 2026-02 author Gaertner Jan Palliative Care Center, Bethesda Spital AG, Basel, Switzerland jan.gaertner@unibas.ch.,Department of Clinical Research, University of Basel, Basel, Switzerland.,Faculty of Medicine, University of Basel, Basel, Switzerland. author Hentsch Lisa Division of Palliative Medicine, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 594583 author Guerreiro Ivan Division of Pneumology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. 631408 author Kannape Oliver Virtual Medicine Centre, HUG-NeuroCentre, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland. 409419 Département des neurosciences cliniques (OTONO) author Delahaye Mathias Virtual Medicine Centre, HUG-NeuroCentre, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland. 447729 Centre universitaire d'informatique (CUINF) author Bianchi Federica Division of Palliative Medicine, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland. 950632 author Cantero Chloe Division of Pneumology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. 659616 author Pautex Sophie Marie Division of Palliative Medicine, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 37604 dept de réadaptation et gériatrie (MIGRG) author Bergeron Anne Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Pneumology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. 981702 Département de médecine (DEMED) author Lövblad Karl-Olof Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neuroradiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland. 135154 Département de radiologie et informatique médicale (RADIO) author Kurz Félix Tobias 0000-0001-7616-7147 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neuroradiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland. 419472 author Fusi-Schmidhauser Tanja 0000-0002-6270-1035 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Palliative and Supportive Care Clinic, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.,Department of Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland. 915491 dept de réadaptation et gériatrie (MIGRG) e107472 10.1136/bmjopen-2025-107472 41692519 2044-6055 PMC12911684 https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2025-107472 Introduction: Dyspnoea is an existentially burdensome symptom in patients with advanced and progressive diseases such as cancer, chronic obstructive pulmonary disease (COPD) and advanced heart failure. Recent studies have highlighted that symptomatic treatment of dyspnoea is often ineffective and may depend on the underlying disease. Immersive virtual reality (IVR) has emerged as a 'digital therapeutic' for conditions such as pain, anxiety, and dyspnoea. Brain functional MRI (fMRI) offers the opportunity to identify distinct patterns of dyspnoea. Current findings are mainly limited to healthy volunteers, but clinical data from patients with life-limiting conditions are needed. The aim of this study is to assess the feasibility of identifying dyspnoea patterns in different life-limiting conditions using fMRI and IVR. Methods and analysis: This is an observational monocentric feasibility study, conducted in a tertiary university centre. Healthy volunteers and patients diagnosed with advanced cancer, COPD, or heart failure and suffering from persistent dyspnoea will undergo an fMRI of the brain using IVR. The primary outcome of feasibility will be evaluated using descriptive statistics. Secondary outcomes include analysis of fMRI patterns of dyspnoea across populations, patient-reported burden of participation, and correlation between dyspnoea and psychological symptoms. These preliminary data will help determine the sample size required for a future study evaluating differences in dyspnoea patterns. Exploratory comparison between the characteristics of all four groups will be assessed with Fisher's test (for proportions) and either independent Student's t-test or Mann-Whitney test, depending on distribution. Correlations between variables will be tested using the Pearson's correlation coefficient. Statistical analysis will be performed using STATA. Ethics and dissemination: This study protocol received ethical approval on 23 April 2025 from the Commission cantonale d'éthique de la recherche in the Canton of Geneva, Switzerland. The identification number is 2024-02289. Submission to peer-reviewed journals and presentation in international congresses for the dissemination of the study findings are planned. Trial registration number: Clinical Trials number is NCT07319039; Pre-results. Brain / diagnostic imaging Brain / physiopathology Dyspnea / diagnostic imaging Dyspnea / etiology Dyspnea / physiopathology Feasibility Studies Female Heart Failure / complications Humans Magnetic Resonance Imaging / methods Male Neoplasms / complications Observational Studies as Topic Pulmonary Disease, Chronic Obstructive / complications Research Design Virtual Reality Dewey 616.8 Dewey 616.0757 Dewey 616 Dewey 618.97 65 Département de réadaptation et gériatrie 22B 56 Département de médecine 221 61 Département des neurosciences cliniques 226 62 Département de radiologie et informatique médicale 227 false 436 Médecine palliative 709 1430 Maladies interstitielles et de l'immunodéprimé 1057 470 Ischémie cérébrale et connectivité 801 BMJ open 16 2 30f9a2ef-0d56-456f-9f13-5cca2e6aa35f Article (Published version) Public BMJ_BREACH_Protocole_2026.pdf 623605 application/pdf CC BY-NC-4.0 cc3588813731f6c3c3a967d04a72cb729ef3a9858319b0d3c18a8919951a7d15 9480b612-ac80-4721-845b-dd8d219a9a9c Supplemental data Public bmjopen-2026-February-16-2--inline-.pdf 329653 application/pdf 0877461b99654ed92e181c0b70616291662d9278fa16604659ef12957b05d4b5 aa8a075a-9825-44ea-a077-8a891d00b25c Supplemental data Public bmjopen-2026-February-16-2--inline-1.pdf 74839 application/pdf fa7a7e5a4ef63c44b185322308567aba6e5006d61a9a00e686baa4cc7f104226 e3d32fd0-1b8d-4f4a-ac87-33d41374abda Supplemental data Public bmjopen-2026-February-16-2--inline-2.pdf 85858 application/pdf c19f042586c70cd6ed1c472bd35976cf554e3bb7b849c09ef9ae40510bc72bb4 17faad77-db0a-46d0-847c-ed0365153374 Supplemental data Public bmjopen-2026-February-16-2--inline-3.pdf 100232 application/pdf ac60f2807754bad21d3c55d7f63544e2710f3c10ed13d5659682a4dc77c24e19 7ee15c8a-2955-479c-932f-5ce54a9337db Supplemental data Public bmjopen-2026-February-16-2--inline-4.pdf 103349 application/pdf 8765263308237161e8d152ee765c3cd7cafdb0efa4c01030fd91c390ef4cf70b f8ad4cc0-5037-46eb-a241-0be2f503f4f0 Supplemental data Public bmjopen-2026-February-16-2--inline-6.pdf 74638 application/pdf 36254e49fb1fb9801a5fa8ef42844cd3eee196638a2b9794ca4e2fe506cab344 4cbc72ce-9ca3-41ce-a1cd-0b8b50605684 Supplemental data Public bmjopen-2026-February-16-2--inline-7.pdf 42127 application/pdf e9a2f49a288bb1d3c76aa8e8777d5126ee3642b939c55891c3700d6eb647978d bde1d0bc-904f-420a-a41a-8a9b405ca13d Supplemental data Public bmjopen-2026-February-16-2--inline-8.pdf 78815 application/pdf 7545a0d6f67b2c56e445d6c2381788e174ba33500af6809eebbb9d3fcfccf60a openAccess Faculté de médecine / Section de médecine clinique / Département de réadaptation et gériatrie Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale

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