<p>Contributions of cardiovascular risk and smoking to chronic obstructive pulmonary disease (COPD)-related changes in brain structure and function</p>

Abstract

BackgroundBrain damage and cardiovascular disease are extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD). Cardiovascular risk factors and smoking are contributors to neurodegeneration. This study investigates whether there is a specific, COPD-related deterioration in brain structure and function independent of cardiovascular risk factors and smoking.Materials and methodsNeuroimaging and clinical markers of brain structure (micro- and macro-) and function (cognitive function and mood) were compared between 27 stable COPD patients (age: 63.0±9.1 years, 59.3% male, forced expiratory volume in 1 second [FEV1]: 58.1±18.0% pred.) and 23 non-COPD controls with >10 pack years smoking (age: 66.6±7.5 years, 52.2% male, FEV1: 100.6±19.1% pred.). Clinical relationships and group interactions with brain structure were also tested. All statistical analyses included correction for cardiovascular risk factors, smoking, and aortic stiffness.ResultsCOPD patients had significantly worse cognitive function (p=0.011), lower mood (p=0.046), and greater gray matter atrophy (p=0.020). In COPD patients, lower mood was associated with markers of white matter (WM) microstructural damage (p<0.001), and lower lung function (FEV1/forced vital capacity and FEV1) with markers of both WM macro (p=0.047) and microstructural damage (p=0.028).ConclusionCOPD is associated with both structural (gray matter atrophy) and functional (worse cognitive function and mood) brain changes that cannot be explained by measures of cardiovascular risk, aortic stiffness, or smoking history alone. These results have important implications to guide the development of new interventions to prevent or delay progression of neuropsychiatric comorbidities in COPD. Relationships found between mood and microstructural abnormalities suggest that in COPD, anxiety, and depression may occur secondary to WM damage. This could be used to better understand disabling symptoms such as breathlessness, improve health status, and reduce hospital admissions.

The effect of acupoint application of traditional Chinese medicine for the treatment of chronic obstructive pulmonary disease

“…Importantly, AECOPD is often caused by microbial infections, [ 23 ] which may induce complications such as respiratory failure and sleep-disordered breathing. [ 24 – 26 ] Acute exacerbation increases the difficulty of treating COPD.…”

Lung function, COPD and cognitive function: a multivariable and two sample Mendelian randomization study

“…One of the proposed mechanisms whereby lung function and COPD may cause reduced cognition is via cerebrovascular pathology [35]. Our outcome population excluded those with history of clinical stroke, this is unlikely to have excluded the proposed COPD specific brain changes, but would have excluded those with large vessel vascular damage causing changes in cognitive function.…”

Factors affecting brain structure in smoking-related diseases: Chronic Obstructive Pulmonary Disease (COPD) and coronary artery disease

“…Scree tests (above the 'elbow' in the eigenvalue scree plot) were used to determine the number of components to extract. Component scores were computed using least squares regression which took into account each marker's contribution to the component, the correlations between markers and correlations between components [20]. For markers that did not load onto a component, the measured values (after age and sex adjustment) were used.…”