A comparison of cognitive functions in non-hypoxemic chronic obstructive pulmonary disease (COPD) patients and age-matched healthy volunteers using mini-mental state examination questionnaire and event-related potential, P300 analysis

Abstract

Objective:To assess sub-clinical cognitive dysfunctions in stable chronic obstructive pulmonary disease (COPD) patients having no hypoxemia vs. age-matched healthy volunteers using (i) an electrophysiological test: Auditory event related potential, P300 test and (ii) a questionnaire tool: Mini-mental state examination (MMSE) questionnaire.Materials and Methods:Eighty male subjects were included: 40 stable COPD patients (smoking history >20 pack years) and 40 healthy volunteers (HVs). Age, duration of illness, smoking pack years, and spirometric indices were assessed. MMSE scores were evaluated in these groups. Latency of P300 wave and amplitude of P300 wave were studied in both groups to detect P300 abnormalities in COPD group. Correlations of P300 abnormalities with patient characteristic parameters and MMSE scores were assessed. In addition, individual COPD patients having significant cognitive dysfunctions beyond cut-off value of 99th percentile of HVs were analyzed.Results:We observed significantly prolonged P300 latency (P < 0.001) and decreased P300 amplitude (P < 0.001) in COPD group. MMSE scores were significantly reduced in COPD group (P < 0.001). 10/40 COPD patients had prolongation of P300 latency, and 27/40 COPD patients had reduced MMSE scores beyond 99th percentile of HV. However, we did not observe any statistically significant correlation between P300 abnormalities and patients’ characteristics or MMSE scores (P > 0.05 for all).Conclusions:Our study explores cognitive dysfunctions in stable COPD patients with no hypoxemia. This study highlights the relative importance of using MMSE and P300. Cognitive dysfunctions were detected both by MMSE and P300; however, MMSE abnormalities were more frequent compared to P300 abnormalities (27/40 vs. 10/40) in COPD patients.

Brain Damage and Motor Cortex Impairment in Chronic Obstructive Pulmonary Disease: Implication of Nonrapid Eye Movement Sleep Desaturation

“…3 However, several studies have provided evidence of cerebral dysfunction in nonhypoxemic COPD patients, indicating that hypoxemia per se is not the main factor. [4][5][6] This observation is unsurprising because an adequate oxygen supply to the brain is permanently ensured through cerebrovascular oxygen (O2) reactivity. During hypoxemia or oxygen desaturation, cerebrovascular O2 reactivity prevents cerebral hypoxia by increasing cerebral blood flow (CBF) up to 200%.…”

Awareness, Attitude and Use of Tobacco among Medical Students in Chennai

“…Similar findings were reported by Selokar et al [ 14 ] and Lam et al [ 15 ], with 10.3% and 11.8% of students having tried cigarette smoking, respectively. In contrast, Alrsheedi et al [ 16 ], Sreeramareddy et al [ 17 ] and Surani et al [ 18 ] reported that 23%, 31.7% and 40% of students tried smoking, respectively. In the present study, among male medical students, one-fourth had ever smoked cigarettes compared with 1.8% among female medical students.…”

Effects of COPD on cognitive functions: a case control study

“…Son dönemde yapılan bir çalışmada hipoksemisi olmayan KOAH hastalarında da kognitif fonksiyonlarda bozulma olduğu gösterilmiştir (17). Ayrıca yaşlı KOAH'lı olgularda kognitif fonksiyonların yaşla ilişkili olarak kan akımında azalma, eğitim durumu, hastalıkla ilişkili olarak arteryel oksijen içeriğinde azalma ve hem hastalık hem de yaş ile ilişkili olarak fiziksel aktivitede azalmayla etkilenebileceği belirtilmiştir (18)(19)(20) hasta grubumuzun da hipoksisi olmayan 50 yaş ve üs-tü hastalardan oluştuğu göz önüne alınırsa kognitif fonksiyonlardaki bu azalmada yaş ve KOAH nedeniyle ortaya çıkan sistemik inflamasyon, oksidatif hasar ve fiziksel aktivitedeki kısıtlanmanın rolü olduğu düşünü-lebilir.…”