Abstract
Subjects with life-threatening asthma (LTA) have reported decreased sensitivity to inspiratory resistive (R) loads. It is unknown if decreased sensitivity is specific for inspiratory R loads, other types of respiratory loads, or a general deficit affecting sensory modalities. This study hypothesized that impairment is specific to respiratory stimuli. This study tested perceptual sensitivity of LTA, asthmatic (A), and nonasthmatic (NA) subjects to 4 sensory modalities: respiratory, somatosensory, auditory, visual. Perceptual sensitivity was measured with magnitude estimation (ME): respiratory loads ME, determined using inspiratory R and pressure threshold (PT) loads; somatosensory ME, determined using weight ranges of 2–20 kg; auditory ME, determined using graded magnitudes of 1 kHz tones delivered for 3 seconds bilaterally; visual ME, determined using gray-to-white disk intensity gradations on black background. ME for inspiratory R loads lessened for LTA over A and NA subjects. There was no significant difference between the 3 groups in ME for PT inspiratory loads, weight, sound, and visual trials. These results demonstrate that LTA subjects are poor perceivers of inspiratory R loads. This deficit in respiratory perception is specific to inspiratory R loads and is not due to perceptual deficits in other types of inspiratory loads, somatosensory, auditory, or visual sensory modalities.
Highlights
Asthma is a respiratory disease frequently diagnosed in childhood
The perceptual sensitivity to resistive and pressure threshold respiratory loads, weight heaviness, sound intensity, and light grayscale contrast were determined for life-threatening asthma (LTA), A, and NA subjects
While the LTA subjects are poor perceivers of inspiratory resistive loads, this deficit in respiratory perception is specific to inspiratory resistive loads and is not due to perceptual deficits in other sensory modalities
Summary
To control and/or prevent an asthma attack, it is important for the patient to heed initial symptoms and to be compliant with their prescribed medication(s). Difficulty in perceiving asthma symptoms can be one of many factors causing the patient to fail to recognize the onset of an asthma attack [2, 4, 5]. A subpopulation of asthmatic patients with a history of LTA has been reported with reduced perception of both intrinsic and extrinsic respiratory loads [2, 4]. These LTA asthmatic patients have an increased threshold for detection of inspiratory resistive loads, a decreased ability to scale the magnitude of inspiratory loads and a decreased perception of intrinsic bronchoconstriction [2, 4]. While it is evident that these LTA subjects have poor perception of respiratory mechanical loads, it is unknown if this is a specific deficit for respiratory mechanosensation or a general sensory perception deficit
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