Alterations of the default mode network and cognitive impairments in patients with chronic obstructive pulmonary disease

Hu, Xueyang; Wang, Haibao; Tu, You-Hui; Fei, Mengdi; Yin, Minmin; Fei, Guanghe; Yu, Yongqiang

doi:10.2147/copd.s146870

Cited by 17 publications

(12 citation statements)

References 37 publications

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“…Structural MRI studies found decreased GM in the dorsolateral PFC [ 11 ], and this part of the brain is involved in executive functions and working memory [ 12 ]. Resting-state fMRI showed that patients with COPD have lower functional connectivity values in the cingulate cortex and PFC [ 34 ]. PFC plays an essential role in executive function, which is considered the higher cognitive function that would be more often affected.…”

Section: Discussionmentioning

confidence: 99%

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Changes in Spatial Working Memory in Stable Chronic Obstructive Pulmonary Disease: A Retrospective Study

Jiang

et al. 2020

BioMed Research International

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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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Section: Discussionmentioning

confidence: 99%

“…* * P ≤ 0:01; * * * P ≤ 0:001. [34]. PFC plays an essential role in executive function, which is considered the higher cognitive function that would be more often affected.…”

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confidence: 99%

Changes in Spatial Working Memory in Stable Chronic Obstructive Pulmonary Disease: A Retrospective Study

Jiang

et al. 2020

BioMed Research International

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“…One study found increased resting-state network activity in patients with COPD compared to healthy controls, but this result was not significant anymore after controlling for oxygen saturation [14]. Another study also found increased default network activation in patients with moderate COPD but decreased activation in those with severe COPD [44]. This result might reflect a compensatory response to damage inflicted by factors associated with COPD, and this response might be strongest in patients with moderate COPD [44].…”

Section: Longitudinal Studiesmentioning

confidence: 99%

Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions

Beers

Janssen

Gosker

et al. 2018

Expert Review of Respiratory Medicine

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Introduction: Cognitive impairment (CI) is an important but an under-recognized extra-pulmonary feature of chronic obstructive pulmonary disease (COPD). It is related to the burden of disability, worse health outcomes, and impaired self-management. Areas covered: CI includes deterioration of a wide range of cognitive functions, such as memory and various executive functions. Risk of hospitalization might be higher in patients with COPD compared to those without, with CI negatively impacting the wellbeing of patients with COPD. Disease-specific factors such as hypoxemia and inflammation, lifestyle factors such as dietary insufficiencies and lack of physical activity, and comorbidities such as obstructive sleep apnea and depression are likely to synergistically contribute to the development of CI in COPD. Tailored interventions can possibly improve CI in COPD, but this needs further investigation. Expert commentary: Further research is warranted involving the optimization of neuropsychological testing for screening and outcome assessment, longitudinal studies to investigate the development of CI in COPD over time, and randomized clinical trials to test the feasibility and efficacy of promising interventions.

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“…Hu et al found that the MMSE score is inversely correlated with the severity of airflow obstruction. 28 However, Dag and Thakur examined cognitive function among stable COPD patients with the MoCA or MMSE, and they did not find any associations between COPD severity measures and the risk of cognitive impairment. 16 , 27 The study conducted by Salik et al showed that cognitive function in COPD patients with mild hypoxemia was similar to that observed for healthy subjects, and no relationship existed between MMSE scores and lung function parameters in either COPD or healthy subjects.…”

Section: Discussionmentioning

confidence: 98%

<p>Moderate-to-Severe Obstructive Sleep Apnea and Cognitive Function Impairment in Patients with COPD</p>

Zhang¹,

Gao²,

Han³

et al. 2020

COPD

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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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Alterations of the default mode network and cognitive impairments in patients with chronic obstructive pulmonary disease

Cited by 17 publications

References 37 publications

Changes in Spatial Working Memory in Stable Chronic Obstructive Pulmonary Disease: A Retrospective Study

Changes in Spatial Working Memory in Stable Chronic Obstructive Pulmonary Disease: A Retrospective Study

Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions

<p>Moderate-to-Severe Obstructive Sleep Apnea and Cognitive Function Impairment in Patients with COPD</p>

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