Brain scans and virtual reality aim to decode chronic breathlessness

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria * Age ≥ 18 years and * Followed by the outpatient palliative care clinic of the Geneva University Hospitals, Switzerland (HUG) and * Breathlessness at rest \> 2 and \< 8 on the NRS (numeric rating scale 0 to 10) and * Persistent breathlessness (persistent dyspnea for \> 3 weeks despite adequate and maximal medication according to the pathology) and * In a stable clinical condition, i.e., without an episode of acute cardiac, respiratory, and/or neurological failure leading to hospitalization in the previous 4 weeks and * Diagnosis of either HF stage NYHA III-IV, or COPD with dyspnea on the modified MRC scale grade 3-4, or oncological disease with primary or secondary pulmonary involvement Inclusion Criteria for Healthy Volunteers (Control Group) * Age ≥ 18 years and * No respiratory symptoms: dyspnea, cough, wheezing and * No known pulmonary, cardiac, or oncological disease and * Smoking status \< 10 pack-years and * No contraindication to fMRI (Appendix 3) and * Ability to lie flat (supine position) and * No diagnosed psychiatric illness (severe depression, severe anxiety, psychosis, other) or antipsychotic treatment deemed a contraindication for fMRI based on physician judgement and * No neurological disorders according to neurological assessment, including diagnosed dementia (frontotemporal dementia, Alzheimer's disease, etc.), brain pathology (tumor, stroke, Parkinson's disease, etc.), or epilepsy and * No claustrophobia, acrophobia, photophobia, severe hearing loss, and/or severe visual deficit and * No contraindication to IVR (migraines, photosensitive epilepsy, vertigo) Exclusion Criteria * Breathlessness at rest ≥ 8 on the NRS (numeric rating scale 0 to 10) * Contraindication to fMRI * Inability to lie flat (supine position) * Diagnosed psychiatric illness (severe depression, severe anxiety, psychosis, other) or antipsychotic treatment deemed a contraindication for fMRI based on physician judgement * Neurological disorders according to neurological assessment, including diagnosed dementia (frontotemporal dementia, Alzheimer's disease, etc.), brain pathology (tumor, stroke, Parkinson's disease, etc.), or epilepsy * Presence of claustrophobia, acrophobia, photophobia, severe hearing loss, and/or severe visual deficit * Contraindication to IVR (migraines, photosensitive epilepsy, vertigo)