Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea.
COPD. 2013 Jun;10(3):357-66. doi: 10.3109/15412555.2012.752808.
Cognitive deficit is a common problem in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to prospectively evaluate if MRI can demonstrate microstructural volume loss and the diffusion anisotropic change in subjects with COPD, compared with cognitively normal (CN) subjects.
Six subjects with severe COPD, 13 with moderate COPD, and 12 CN subjects underwent isotropic volumetric T1-weighted imaging and diffusion tensor imaging (DTI). Voxel-based statistical analyses among groups were performed on brain volumes, fractional anisotropy (FA) and trace. Cognitive function tests were performed in all subjects, and the Cognitive function tests (CFT) scores were compared among the three groups.
No significant regional difference in volume was found in both the severe and moderate COPD groups relative to the CN group. Comparing between severe COPD and CN, FA was reduced in both the cerebral cortices, and in frontoparietal periventricular white matter. The trace value of the severe COPD group was significantly higher in the cerebral cortices, and in frontoparietal periventricular white matter, than that of the CN group. The severe COPD group showed significantly lower scores in the language-related, visuospatial, and frontal executive functions compared to those of the CN and moderate COPD group.
This study demonstrated that COPD could affect the axonal integrity in multiple brain regions, and change in DTI might be related with the severity of the COPD.
认知缺陷是慢性阻塞性肺疾病（COPD）患者的常见问题。本研究旨在前瞻性评估 MRI 是否可以显示 COPD 患者与认知正常（CN）患者相比存在脑微结构体积损失和弥散各向异性变化。
6 名重度 COPD 患者、13 名中度 COPD 患者和 12 名 CN 患者接受了各向同性容积 T1 加权成像和弥散张量成像（DTI）检查。对三组间脑容量、各向异性分数（FA）和Trace 值进行基于体素的统计分析。所有受试者均进行认知功能测试，并比较三组间的认知功能测试（CFT）评分。
重度和中度 COPD 组相对于 CN 组，脑容量无明显区域性差异。与 CN 组相比，重度 COPD 患者大脑皮质和额顶脑室周围白质的 FA 降低。重度 COPD 组大脑皮质和额顶脑室周围白质的 Trace 值明显高于 CN 组。与 CN 组和中度 COPD 组相比，重度 COPD 组在语言相关、视空间和额叶执行功能方面的得分明显较低。
本研究表明，COPD 可能会影响多个脑区的轴突完整性，DTI 的变化可能与 COPD 的严重程度有关。
