Chest
Original Research: COPDStructural Brain Changes in Patients With COPD
Section snippets
Participants
Thirty stable outpatients with moderate to severe COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stage II and III)1 were recruited at the Pulmonary Research Institute (LungClinic Grosshansdorf; n = 20) and at an outpatient pulmonary rehabilitation center (Atem-Reha Hamburg; n = 10). Patients’ demographics and medical histories, including disease duration, were obtained from their medical records. Thirty control subjects without history of respiratory disease (FEV1 in
Participants
Means and SDs of baseline characteristics are reported in Table 1. Patients with COPD and control subjects did not differ significantly regarding age, sex, height, weight, and BMI. As expected, the COPD group showed lower lung function in FEV1 % predicted, FVC % predicted, and FEV1/FVC (all P < .001), and contained more smokers compared with the control group (P < .001). All participants were within the normal range of HADS anxiety and depression scores, that is, below the clinically relevant
Discussion
This study is one of the first to investigate structural brain changes in patients with COPD using VBM and several important findings were obtained. Patients with COPD showed no general reductions in MRI brain volume of gray matter, white matter, or total intracranial volume compared with matched healthy control subjects. In contrast, patients with COPD showed regionally decreased GMV within the PCC (whole-brain analysis) as well as in ACC, MCC, HC, and AMYG (small-volume analysis) when
Conclusions
Compared with healthy control subjects, patients with COPD showed decreased GMV in ACC, MCC, and PCC, HC, and AMYG in the absence of generalized cortical degeneration. The affected brain areas are involved in the processing of dyspnea, fear, and antinociception. Moreover, decreased gray matter in the ACC in patients with COPD was related to longer disease duration, and greater fear of dyspnea and fear of physical activity, which—via behavioral mechanisms—might negatively influence the course of
Acknowledgments
Author contributions: R. W. E. and A. v. L. had full access to all of the data in the study and take full responsibility for the integrity of the data and accuracy of the data analysis, including and especially any adverse effects. R. W. E., M. C. S., H. M., and A. v. L. contributed to study conception and design; R. W. E., M. C. S., A. K., H. W., K. T., and K. L. contributed to data acquisition; R. W. E., M. C. S., S. P., and A. v. L. contributed to data analysis and interpretation of data; R.
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FUNDING/SUPPORT: This study was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft [DFG]) by a stipend [Heisenberg-Stipendium, LE 1843/9-2] and two grants [LE 1843/10-1, LE 1843/10-3] to Dr von Leupoldt.