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Zhu Z, Wu Y, Qu L, Zou Y, Nie G, Xu S, Zhou Q, Zhang Y, Chen R. Evaluation of nocturnal apnea and airflow limitation as indicators for cognitive dysfunction in patients with chronic obstructive pulmonary disease/obstructive sleep apnea hypopnea syndrome overlap syndrome. Chron Respir Dis 2024; 21:14799731241236492. [PMID: 38411460 PMCID: PMC10901067 DOI: 10.1177/14799731241236492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVE The aim of this study is to investigate how much intermittent hypoxemia and airflow limitation contribute to cognitive impairment in overlap syndrome (OS), which is the coexistence of two common diseases, obstructive sleep apnea hypopnea syndrome (OSAHS) and chronic obstructive pulmonary disease (COPD). METHODS We conducted a cross-sectional study of patients with OSAHS, COPD or OS, compared with normal controls, to determine the association between sleep apnea/pulmonary function-related indicators and cognitive dysfunction in individuals with OSAHS, COPD or OS. RESULTS A total of 157 participants were recruited. Both OSAHS and OS presented lower adjusted Montreal cognitive assessment (MoCA) scores compared with COPD group. In addition, the MoCA score was significantly lower in COPD group compared with control group. The incidence of cognitive impairment was 57.4% in OSAHS group, and 78% in OS group, which were significantly higher than COPD group (29%) and control group (8.8%). Furthermore, a broader range of cognitive domains were affected in OS group compared with OSAHS group. Elevated levels of oxygen desaturation index (ODI) and/or apnea hypopnea index (AHI) were positively correlated with increased Epworth sleeping scale (ESS) in OSAHS and OS. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) were positively correlated with cognitive scores in OSAHS but not in OS. Serum level of hypoxia-inducible factor-1α (HIF-1α) was significantly higher in OS. Logistic regression identified ODI as an independent risk factor for cognitive impairment in OS, while severity of snoring and PEF were independent risk factors in OSAHS. DISCUSSION This study revealed significant cognitive impairment in OS, OSAHS and COPD. Sleep-related indicators are warranted in OS patients for detection, differentiation and grading of cognitive impairment, whereas pulmonary functions are warranted in OSAHS patients for detection and early intervention of cognitive impairment.
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Affiliation(s)
- Zheng Zhu
- Department of Respiratory, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Yaohua Wu
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Ling Qu
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Ying Zou
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Guozhong Nie
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Shuguang Xu
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Qixing Zhou
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Yunfeng Zhang
- Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District Liqun Hospital, Shanghai, China
| | - Rui Chen
- Department of Respiratory, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Sleep Center, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Wang M, Wang Y, Wang Z, Ren Q. The Abnormal Alternations of Brain Imaging in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review. J Alzheimers Dis Rep 2023; 7:901-919. [PMID: 37662615 PMCID: PMC10473125 DOI: 10.3233/adr-220083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 07/11/2023] [Indexed: 09/05/2023] Open
Abstract
Background Cognitive impairment (CI) is an important extrapulmonary complication in patients with chronic obstructive pulmonary disease (COPD). Multimodal Neuroimaging Examination can display changes in brain structure and functions in patients with COPD. Objective The purpose of this systematic review is to provide an overview of the variations in brain imaging in patients with COPD and their potential relationship with CI. Furthermore, we aim to provide new ideas and directions for future research. Methods Literature searches were performed using the electronic databases PubMed, Scopus, and ScienceDirect. All articles published between January 2000 and November 2021 that met the eligibility criteria were included. Results Twenty of the 23 studies focused on changes in brain structure and function. Alterations in the brain's macrostructure are manifested in the bilateral frontal lobe, hippocampus, right temporal lobe, motor cortex, and supplementary motor area. The white matter microstructural changes initially appear in the bilateral frontal subcortical region. Regarding brain function, patients with COPD exhibited reduced frontal cerebral perfusion and abnormal alterations in intrinsic brain activity in the bilateral posterior cingulate cortex, precuneus, right lingual gyrus, and left anterior central gyrus. Currently, there is limited research related to brain networks. Conclusion CI in patients with COPD may present as a type of dementia different from Alzheimer's disease, which tends to manifest as frontal cognitive decline early in the disease. Further studies are required to clarify the neurobiological pathways of CI in patients with COPD from the perspective of brain connectomics based on the whole-brain system in the future.
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Affiliation(s)
- Mengxue Wang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Yanjuan Wang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Zan Wang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Qingguo Ren
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
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Tsai CL, Chang WP, Lin YK, Ho SC, Lin YH. Physical frailty related to cognitive impairment and COPD exacerbation: A cross-sectional study. Respir Med 2023; 208:107129. [PMID: 36709919 DOI: 10.1016/j.rmed.2023.107129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023]
Affiliation(s)
- Chen-Liang Tsai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| | - Wen Pei Chang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan.
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yu-Huei Lin
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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Tang F, Li L, Peng D, Yu J, Xin H, Tang X, Li K, Zeng Y, Xie W, Li H. Abnormal static and dynamic functional network connectivity in stable chronic obstructive pulmonary disease. Front Aging Neurosci 2022; 14:1009232. [PMID: 36325191 PMCID: PMC9618865 DOI: 10.3389/fnagi.2022.1009232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/26/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Many studies have explored the neural mechanisms of cognitive impairment in chronic obstructive pulmonary disease (COPD) patients using the functional MRI. However, the dynamic properties of brain functional networks are still unclear. The purpose of this study was to explore the changes in dynamic functional network attributes and their relationship with cognitive impairment in stable COPD patients. Materials and methods The resting-state functional MRI and cognitive assessments were performed on 19 stable COPD patients and 19 age-, sex-, and education-matched healthy controls (HC). We conducted the independent component analysis (ICA) method on the resting-state fMRI data, and obtained seven resting-state networks (RSNs). After that, the static and dynamic functional network connectivity (sFNC and dFNC) were respectively constructed, and the differences of functional connectivity (FC) were compared between the COPD patients and the HC groups. In addition, the correlation between the dynamic functional network attributes and cognitive assessments was analyzed in COPD patients. Results Compared to HC, there were significant differences in sFNC among COPD patients between and within networks. COPD patients showed significantly longer mean dwell time and higher fractional windows in weaker connected State I than that in HC. Besides, in comparison to HC, COPD patients had more extensive abnormal FC in weaker connected State I and State IV, and less abnormal FC in stronger connected State II and State III, which were mainly located in the default mode network, executive control network, and visual network. In addition, the dFNC properties including mean dwell time and fractional windows, were significantly correlated with some essential clinical indicators such as FEV1, FEV1/FVC, and c-reactive protein (CRP) in COPD patients. Conclusion These findings emphasized the differences in sFNC and dFNC of COPD patients, which provided a new perspective for understanding the cognitive neural mechanisms, and these indexes may serve as neuroimaging biomarkers of cognitive performance in COPD patients.
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Affiliation(s)
- Fuqiu Tang
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lan Li
- Department of Infection Management, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, China
| | - Dechang Peng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jingjing Yu
- Department of Respiratory and Critical Care, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huizhen Xin
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xuan Tang
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Kunyao Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yaping Zeng
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Xie
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haijun Li
- Medical Imaging Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- PET Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Haijun Li,
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Bahramabadi R, Yousefi-Daredor H, Rezaeinejad S, Rezayati M, Arababadi MK. Down-regulation of transforming growth factor-beta and interleukin-6 serum levels in the idiopathic chronic obstructive pulmonary disease. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2022; 11:45-50. [PMID: 35874467 PMCID: PMC9301057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Idiopathic chronic obstructive pulmonary disease (ICOPD) is a prevalent human disease. The etiology of the disease is yet to be clarified. The main aim of this project was to explore serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) in the ICOPD patients in comparison to healthy controls. METHODS In this cross-sectional study, serum levels of IL-6, TNF-α and TGF-β were evaluated in the 70 non-smoker ICOPD patients and 70 sex and age matched controls, using ELISA technique by the commercial kits from Karmania Pars Gene Company. Analysis of data was performed by parametric independent and Pearson correlation test. RESULTS Serum levels of IL-6 and TGF-β, but not TNF-α, were significantly decreased in the ICOPD patients in comparison to controls. Serum levels of IL-6, TNF-α and TGF-β were not altered in the ICOPD male in comparison to female and also in mild when compared to moderate ICOPD patients. CONCLUSIONS Down-regulation of TGF-β may be the main risk factor for deterioration of inflammation in the ICOPD patients. Decreased IL-6 may be related to the idiopathic type of COPD.
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Affiliation(s)
- Reza Bahramabadi
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical SciencesRafsanjan, Iran
- Department of Immunology, Faculty of Medicine, Rafsanjan University of Medical SciencesRafsanjan, Iran
| | - Hassan Yousefi-Daredor
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical SciencesRafsanjan, Iran
- Department of Laboratory Sciences, Faculty of Paramedical, Rafsanjan University of Medical SciencesRafsanjan, Iran
| | - Sahar Rezaeinejad
- Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical SciencesRafsanjan, Iran
| | - Mohammadtaghi Rezayati
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical SciencesRafsanjan, Iran
- Department of Immunology, Faculty of Medicine, Rafsanjan University of Medical SciencesRafsanjan, Iran
| | - Mohammad Kazemi Arababadi
- Immunology of Infectious Diseases Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical SciencesRafsanjan, Iran
- Department of Laboratory Sciences, Faculty of Paramedical, Rafsanjan University of Medical SciencesRafsanjan, Iran
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Asthma Induces Psychiatric Impairments in Association With Default Mode and Salience Networks Alteration: A Resting-state EEG Study. Respir Physiol Neurobiol 2022; 300:103870. [DOI: 10.1016/j.resp.2022.103870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/19/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
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Lai X, Sun J, He B, Li D, Wang S, Zhan S. Associations between pulmonary function and cognitive decline in the middle-aged and older adults: evidence from the China Health and Retirement Longitudinal Study. Environ Health Prev Med 2022; 27:48. [PMID: 36529486 PMCID: PMC9792564 DOI: 10.1265/ehpm.22-00158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/12/2022] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Studies observing the relationship between pulmonary function and the risk of cognitive impairment in middle-aged and older adults was increasing, but the results were inconsistent. To date, evidence from longitudinal data is scarce and further research is urgently needed. METHODS We used data from the China Health and Retirement Longitudinal Study. Participants were enrolled in 2011/2013 and followed up in 2013, 2015 and 2018. Pulmonary function was assessed via peak expiratory flow (PEF). Cognitive function, measured by episodic memory and mental status, was assessed through a face-to-face interview in each survey. RESULTS A total of 8,274 participants (52.86% males; mean age, 56.44 years) were included. The scores of global cognition (12.46 versus 11.51, P < 0.001) of men were significantly higher than women at baseline, with a total of 5096 participants (61.59%) declining during the follow-up. Higher baseline PEF was associated with lower absolute decline in global cognition (OR per 1-SD difference 0.921; P = 0.031) and mental status (OR per 1-SD difference 0.9889; P = 0.002) during follow-up in men, and significant associations between higher baseline PEF and a lower absolute decline in the episodic memory were both found in men (OR per 1-SD difference 0.907; P = 0.006) and women (OR per 1-SD difference 0.915; P = 0.022). Second analysis showed that the significant associations between positive PEF variation and a lower rate of 4-year decline in global cognition, mental status and episodic memory were all only found in men. In subgroup analyses, higher PEF at baseline was significantly associated with a lower absolute decline of global cognition among male individuals >60 years. Significant associations between higher PEF at baseline and lower absolute decline in global cognition and episodic memory during follow-up were only found in never-smokers, while higher PEF was related to lower absolute decline in mental status among non-smoking and smoking males. CONCLUSIONS Pulmonary function correlates with cognitive functions in middle-aged and older people, especially males. Additional studies characterizing early and long-term PEF changes are needed.
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Affiliation(s)
- Xuefeng Lai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jian Sun
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, China
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan 250021, China
- Shandong Key Laboratory of Infectious Respiratory Disease, Jinan 250021, China
| | - Bingjie He
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Daowei Li
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, China
- Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan 250021, China
- Shandong Key Laboratory of Infectious Respiratory Disease, Jinan 250021, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing 100191, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100191, China
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Moy ML, Daniel RA, Cruz Rivera PN, Mongiardo MA, Goldstein RL, Higgins DM, Salat DH. Co-occurrence of pain and dyspnea in Veterans with COPD: Relationship to functional status and a pilot study of neural correlates using structural and functional magnetic resonance imaging. PLoS One 2021; 16:e0254653. [PMID: 34265003 PMCID: PMC8282042 DOI: 10.1371/journal.pone.0254653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/23/2021] [Indexed: 11/18/2022] Open
Abstract
Persons with COPD experience co-occurring dyspnea and pain. Little is known about the relationship between symptom co-occurrence with physical activity (PA) and exercise. Novel diagnostic tools are needed for accurate symptom discrimination. In this secondary analysis, we examined relationships between baseline assessments of pain, dyspnea, objectively measured PA, and exercise capacity in persons with COPD who previously enrolled in three PA studies. Pain was assessed with the bodily pain domain of the Veterans RAND-36 (VR-36), and dyspnea with the modified Medical Research Council (mMRC) scale. Average daily step count was assessed with the Omron HJ-720ITC or FitBit Zip pedometer, and exercise capacity with 6-minute walk test (6MWT). We also conducted a pilot neuroimaging study. Neuroimaging data were acquired on a Siemens 3-Tesla Magnetom Prismafit whole-body scanner. Analysis of variance assessed trends in daily step count and 6MWT distance across categories of co-occurring pain and dyspnea. General linear models examined relationships between cortical thickness and resting state functional connectivity (fc) with symptoms and functional status. In 373 Veterans, 98% were male with mean age 70.5± 8.3 years and FEV1% predicted 59 ± 21%. Compared to those with no co-occurrence of pain and dyspnea, those with co-occurrence walked 1,291-1,444 fewer steps per day and had an 80-85 m lower 6MWT distance. Ten males participated in the pilot neuroimaging study. Predominant findings were that lower cortical thickness and greater fc were associated with higher pain and dyspnea, p<0.05. Greater cortical thickness and lower fc were associated with higher daily step count and 6MWT distance, p<0.05. Regional patterns of associations differed for pain and dyspnea, suggesting that cortical thickness and fc may discriminate symptoms. Co-occurring dyspnea and pain in COPD are associated with significant reductions in PA and exercise capacity. It may be feasible for neuroimaging markers to discriminate between pain and dyspnea.
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Affiliation(s)
- Marilyn L. Moy
- Pulmonary, Critical Care, and Sleep Medicine Service, VA Boston Healthcare System, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Rinu A. Daniel
- Boston University School of Medicine, Boston, MA, United States of America
| | - Paola N. Cruz Rivera
- Pulmonary, Critical Care, and Sleep Medicine Service, VA Boston Healthcare System, Boston, MA, United States of America
| | - Maria A. Mongiardo
- Pulmonary, Critical Care, and Sleep Medicine Service, VA Boston Healthcare System, Boston, MA, United States of America
| | - Rebekah L. Goldstein
- Pulmonary, Critical Care, and Sleep Medicine Service, VA Boston Healthcare System, Boston, MA, United States of America
| | - Diana M. Higgins
- Boston University School of Medicine, Boston, MA, United States of America
- Anesthesiology, Critical Care, and Pain Medicine Service, VA Boston Healthcare System, Boston, MA, United States of America
| | - David H. Salat
- Harvard Medical School, Boston, MA, United States of America
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States of America
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Li H, Xin H, Yu J, Yu H, Zhang J, Wang W, Peng D. Abnormal intrinsic functional hubs and connectivity in stable patients with COPD: a resting-state MRI study. Brain Imaging Behav 2021; 14:573-585. [PMID: 31187474 PMCID: PMC7160072 DOI: 10.1007/s11682-019-00130-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) affects a large population and is closely associated with cognitive impairment. However, the mechanisms of cognitive impairment in COPD patients have not been unraveled. This study investigated the change in patterns of intrinsic functional hubs using a degree centrality (DC) analysis. The connectivity between these abnormal hubs with the remaining brain was also investigated using functional connectivity (FC). Nineteen stable patients with COPD and 20 normal controls(NC) underwent functional magnetic resonance imaging (MRI) examinations and clinical and neuropsychologic assessments. We measured the voxel-wise DC across the whole brain gray matter and the seed-based FC between these abnormal hubs in the remaining brain matter; the group difference was calculated. A partial correlation analysis was performed to assess the relationship between the abnormal DC and clinical variables in COPD patients. Compared to NC, the patients with COPD exhibited significantly decreased DC in the right lingual gyrus (LG), bilateral supplementary motor area (SMA), and right paracentral lobule (PCL). A further seed-based FC analysis found that COPD patients demonstrated significantly decreased FC between these abnormal hubs in several brain areas, including the left cerebellum anterior lobe, left lingual gyrus, left fusiform gyrus, right insula, right inferior frontal gyrus, limbic lobe, cingulate gyrus, left putamen, lentiform nucleus, right precuneus, and right paracentral lobule. A partial correlation analysis showed that the decreased DC in the right PCL was positively correlated with the FEV1 and FEV1/FVC, and the decreased DC in the SMA was positively correlated with naming and pH in COPD patients. This study demonstrates that there are intrinsic functional hubs and connectivity alterations that may reflect the aberrant information communication in the brain of COPD patients. These findings may help provide new insight for understanding the mechanisms of COPD-related cognitive impairment from whole brain functional connections.
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Affiliation(s)
- Haijun Li
- Department of Radiology, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Huizhen Xin
- Department of Radiology, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Jingjing Yu
- Department of Respiratory, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Honghui Yu
- Department of Radiology, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Juan Zhang
- Department of Radiology, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Wenjing Wang
- Department of Respiratory, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dechang Peng
- Department of Radiology, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China.
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Yu J, Wang W, Peng D, Luo J, Xin H, Yu H, Zhang J, Li L, Li H. Intrinsic low-frequency oscillation changes in multiple-frequency bands in stable patients with chronic obstructive pulmonary disease. Brain Imaging Behav 2020; 15:1922-1933. [PMID: 32880076 DOI: 10.1007/s11682-020-00385-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abnormal local spontaneous brain activity during the resting state has been observed in chronic obstructive pulmonary disease (COPD). However, it is still largely unclear whether the abnormalities are related to specific frequency bands. Our purpose was to explore intrinsic neural activity changes in different frequency bands by using the amplitude of low-frequency fluctuation (ALFF) method in stable COPD patients. Nineteen stable COPD patients and twenty gender-, age- and education-matched normal controls (NCs) underwent functional magnetic resonance imaging scans, cognitive function tests and lung function tests. Two different frequency bands (slow-4: 0.027-0.073 Hz; slow-5: 0.01-0.027 Hz) were calculated and analyzed for frequency-dependent intrinsic neural activity by using the ALFF method. A two-way analysis of variance test was used to compare the main effects of the groups and the frequency bands in the ALFF method. Further post-hoc t-tests were used to compare the differences between COPD patients and NCs in terms of the different frequency bands. A Pearson's correlation analysis was performed to explore the relationship between the altered ALFF brain areas in the different frequency bands and the clinical evaluations in the COPD patients. There were main effects of the groups including significantly higher ALFF values in the right superior temporal gyrus (STG), the bilateral cerebellum posterior lobe (CPL), the right lingual gyrus (LG) and the right brainstem, and as well as significantly decreased ALFF values in the right inferior parietal lobule (IPL) and the angular. The main effect of frequency was demonstrated in the CPL, the STG, the prefrontal cortex and the middle cingulate gyrus. Furthermore, COPD patients exhibited more widespread alterations in intrinsic brain activity in the slow-5 band than in the slow-4 band. Moreover, the abnormal intrinsic brain activity in the slow-4 and slow-5 bands were associated with PaCO2 in COPD patients. These current results indicated that COPD patients showed abnormal intrinsic brain activity in two different frequency bands, and abnormal intrinsic neuronal activity in different brain regions could be better detected by slow-5 band. These observations may provide a neoteric view into understanding the local neural psychopathology in stable COPD patients.
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Affiliation(s)
- Jingjing Yu
- Department of Respiratory, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wenjing Wang
- Department of Respiratory, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dechang Peng
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Juan Luo
- Department of Respiratory, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huizhen Xin
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Honghui Yu
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Juan Zhang
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China
| | - Lan Li
- Jiangxi Provincial Institute of Parasitic Diseases Control, No.239, Gaoxin two road, Qingshanhu District, Nanchang, 330096, Jiangxi Province, People's Republic of China.
| | - Haijun Li
- Department of Radiology, Jiangxi Province Medical Imaging Research Institute, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China.
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11
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Zhang XL, Gao B, Han T, Xiang BY, Liu X. Moderate-to-Severe Obstructive Sleep Apnea and Cognitive Function Impairment in Patients with COPD. Int J Chron Obstruct Pulmon Dis 2020; 15:1813-1822. [PMID: 32801679 PMCID: PMC7396955 DOI: 10.2147/copd.s257796] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/15/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Prior studies have indicated that patients with chronic obstructive pulmonary disease (COPD) exhibit significant cognitive defects on neuropsychological testing. Obstructive sleep apnea (OSA) is common in patients with COPD and is associated with reduced cognitive function; however, the combined impact of these two conditions on cognitive function is unknown. The aim of the study was to investigate the impact of OSA on cognitive impairment in patients with COPD. Methods Sixty-five stable COPD patients aged over 60 years underwent overnight polysomnography (PSG). Global cognitive functions were evaluated using the Mini-Mental State Examination (MMSE). Results Compared to patients with COPD alone, patients with both COPD and OSA performed worse on the MMSE (25.5±2.9 vs 23.5±3.2; p=0.01) and were more likely to be at risk for developing dementia based on the MMSE score (MMSE≤24) (31% vs 66%; p<0.01), independent of key demographic, educational and medical variables known to affect cognitive function in COPD. COPD patients with an apnea hypopnea index (AHI) of ≥30 events/h had lower MMSE scores than those with an AHI of <15 events/h. In addition to age and education level, the severity of nocturnal intermittent hypoxia is an independent predictor of the risk of dementia in patients with COPD (OR=1.24, 95% CI 1.04-1.48, p = 0.02). Conclusion The current findings indicate that patients with COPD with comorbid OSA may be at greater risk for global cognitive impairment relative to patients with COPD alone. The mechanisms underlying the exaggerated cognitive dysfunction seem to be related to intermittent hypoxia. Further work is needed to understand the impact of OSA on the specific domains of cognitive impairment and the therapeutic implications of OSA in COPD.
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Affiliation(s)
- Xiao Lei Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,Capital Medical University, Beijing, People's Republic of China.,The Graduate School of Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.,Peking University Health Science Center, Beijing, People's Republic of China
| | - Bo Gao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,Capital Medical University, Beijing, People's Republic of China
| | - Teng Han
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China
| | - Bo Yun Xiang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China
| | - Xin Liu
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China
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12
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Changes in Spatial Working Memory in Stable Chronic Obstructive Pulmonary Disease: A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7363712. [PMID: 32775438 PMCID: PMC7396050 DOI: 10.1155/2020/7363712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/06/2020] [Accepted: 07/11/2020] [Indexed: 12/02/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation and is often accompanied by cognitive impairment. Little is known about the working memory of COPD patients. The aim of the study is to evaluate the spatial working memory of COPD patients using the classical visuospatial working memory neuropsychological paradigms. This was a retrospective study of patients with COPD who were evaluated for neurocognitive functions between February and December 2018 at Hefei Second People's Hospital. Healthy controls (HC) were included. The neuropsychological tests included the Beijing Version of the Montreal Cognitive Assessment Test (MoCA), digit span test (DS), Chinese Auditory Verbal Learning Test (CAVLT), Stroop test, and Verbal Fluency Test (VFT). The COPD group performed worse in MoCA (22.3 ± 4.5 vs. 26.1 ± 2.9, P < 0.001), Stroop interference test (44.2 ± 16.9 vs. 36.8 ± 10.3, P = 0.038), and VFT (12.9 ± 2.8 vs. 15.3 ± 4.7, P = 0.021) vs. the HC group. Compared with the HC group, COPD patients had statistically significant differences with respect to 0-back RT (657 ± 46 vs. 578 ± 107, P = 0.001), 1-back accuracy (41.8 ± 12.1% vs. 81.5 ± 18.1%, P < 0.001), 1-back RT (592 ± 75 vs. 431 ± 138, P < 0.001), 2-back accuracy (31.4 ± 9.9% vs. 68.1 ± 16.6%, P < 0.001), and 2-back RT (563 ± 79 vs. 455 ± 153, P = 0.002). Only PaO2 was independently associated with 0-back RT (B = 0.992 ± 0.428, P = 0.028) and 1-back ACC (B = 0.003 ± 0.001, P = 0.004). COPD patients exhibit impairment in working memory and executive function, but not in short- or long-term memory. The impairment of working memory in a patient with COPD may be more due to integrate memory information rather than to memory information storage. COPD patients exhibit a frontal-type cognitive decline.
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13
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Pelgrim CE, Peterson JD, Gosker HR, Schols AMWJ, van Helvoort A, Garssen J, Folkerts G, Kraneveld AD. Psychological co-morbidities in COPD: Targeting systemic inflammation, a benefit for both? Eur J Pharmacol 2018; 842:99-110. [PMID: 30336140 DOI: 10.1016/j.ejphar.2018.10.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/24/2018] [Accepted: 10/08/2018] [Indexed: 12/15/2022]
Abstract
COPD is a chronic lung disease characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities. Furthermore, COPD is often characterized by extrapulmonary manifestations and comorbidities worsening COPD progression and quality of life. A neglected comorbidity in COPD management is mental health impairment defined by anxiety, depression and cognitive problems. This paper summarizes the evidence for impaired mental health in COPD and focuses on current pharmacological intervention strategies. In addition, possible mechanisms in impaired mental health in COPD are discussed with a central role for inflammation. Many comorbidities are associated with multi-organ-associated systemic inflammation in COPD. Considering the accumulative evidence for a major role of systemic inflammation in the development of neurological disorders, it can be hypothesized that COPD-associated systemic inflammation also affects the function of the brain and is an interesting therapeutic target for nutra- and pharmaceuticals.
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Affiliation(s)
- Charlotte E Pelgrim
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Julia D Peterson
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Harry R Gosker
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Respiratory Medicine, Maastricht, the Netherlands
| | - Annemie M W J Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Respiratory Medicine, Maastricht, the Netherlands
| | - Ardy van Helvoort
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Respiratory Medicine, Maastricht, the Netherlands; Nutrition, Metabolism and Muscle Sciences, Nutricia Research, Utrecht, the Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands; Platform Immunology, Nutricia Research, Utrecht, the Netherlands
| | - Gert Folkerts
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Aletta D Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands; Veterinary Pharmacology & Therapeutics, Institute of Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
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14
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van Beers M, Janssen DJA, Gosker HR, Schols AMWJ. Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions. Expert Rev Respir Med 2018; 12:1061-1074. [DOI: 10.1080/17476348.2018.1533405] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Martijn van Beers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Daisy J. A. Janssen
- Department of Research & Education, CIRO, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Harry R. Gosker
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Annemie M. W. J. Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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15
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Wang W, Li H, Peng D, Luo J, Xin H, Yu H, Yu J. Abnormal intrinsic brain activities in stable patients with COPD: a resting-state functional MRI study. Neuropsychiatr Dis Treat 2018; 14:2763-2772. [PMID: 30425494 PMCID: PMC6200435 DOI: 10.2147/ndt.s180325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The majority of previous neuroimaging studies have reported both structural and functional changes in COPD, whereas the intrinsic low-frequency oscillations changes and the relationship between the abnormal brain regions and the clinical performances remain unknown. The present study was conducted with the aim of evaluating the intrinsic brain activity in COPD patients using the amplitude of low-frequency fluctuation (ALFF) method. METHODS All participants, including 19 stable patients with COPD and 20 normal controls (NCs) matched in age, sex, and education, underwent resting-state functional MRI scans and performed cognitive function tests and respiratory functions tests. The local spontaneous brain activity was examined using the voxel-wise ALFF. Pearson's correlation analysis was used to investigate the relationships between the brain regions with altered ALFF signal values and the clinical features in COPD patients. RESULTS Compared with the NCs, COPD patients showed significantly lower cognitive function scores. Also, lower ALFF areas in the cluster of the posterior cingulate cortex (PCC) and precuneus, as well as a higher ALFF area in the brainstem were also found in COPD patients. The mean ALFF values in the PCC, precuneus, and brainstem showed high sensitivity and specificity in operating characteristic curves analysis, which might have the ability to distinguish COPD from NCs. Meanwhile, the mean signal values of the lower ALFF cluster displayed significant positive correlations with FEV1/FVC proportion and significant negative correlation with PaCO2; the higher ALFF cluster showed significant positive correlation with FEV1 proportion in COPD. CONCLUSION According to the results of the present study, the COPD patients showed abnormal intrinsic brain activities in the precuneus, PCC, and brainstem, which might provide useful information to better understand the underlying pathophysiology of cognitive impairment.
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Affiliation(s)
- Wenjing Wang
- Department of Respiratory, The First Affiliated Hospital of Nanchang University, Nanchang, China,
| | - Haijun Li
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dechang Peng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Juan Luo
- Department of Respiratory, The First Affiliated Hospital of Nanchang University, Nanchang, China,
| | - Huizhen Xin
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Honghui Yu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jingjing Yu
- Department of Respiratory, The First Affiliated Hospital of Nanchang University, Nanchang, China,
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