{
  "abstract": "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.",
  "authors": [
    {
      "affiliations": [
        "Palliative Care Center, Bethesda Spital AG, Basel, Switzerland",
        "Department of Clinical Research, University of Basel, Basel, Switzerland",
        "Faculty of Medicine, University of Basel, Basel, Switzerland"
      ],
      "name": "Jan Gaertner"
    },
    {
      "affiliations": [
        "Division of Palliative Medicine, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland",
        "Faculty of Medicine, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Lisa Hentsch"
    },
    {
      "affiliations": [
        "Division of Pneumology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Ivan Guerreiro"
    },
    {
      "affiliations": [
        "Virtual Medicine Centre, HUG-NeuroCentre, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Oliver A Kannape"
    },
    {
      "affiliations": [
        "Virtual Medicine Centre, HUG-NeuroCentre, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Mathias Delahaye"
    },
    {
      "affiliations": [
        "Division of Palliative Medicine, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Federica Bianchi"
    },
    {
      "affiliations": [
        "Division of Pneumology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Chloe Cantero"
    },
    {
      "affiliations": [
        "Division of Palliative Medicine, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland",
        "Faculty of Medicine, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Sophie Pautex"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Division of Pneumology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Anne Bergeron"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Division of Neuroradiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Karl-Olof Lovblad"
    },
    {
      "affiliations": [
        "Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Division of Neuroradiology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Felix Tobias Kurz"
    },
    {
      "affiliations": [
        "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"
      ],
      "name": "Tanja Fusi-Schmidhauser"
    }
  ],
  "title": "Dyspnoea patterns in patients with advanced diseases: a functional MRI feasibility study protocol",
  "uid": "da197cbd-f174-583c-ba1e-40bb597a35dc"
}