Wang Chunrong, Ding Yanhui, Shen Bixian, Gao Dehong, An Jie, Peng Kewen, Hou Gangqiang, Zou Liqiu, Jiang Mei, Qiu Shijun
Department of Radiology, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou, Guangdong, 510515, China.
Department of Radiology, Nanshan Hospital Affiliated to Guangdong Medical University, Shenzhen, Guangdong, 518052, China.
Neurotox Res. 2017 May;31(4):453-463. doi: 10.1007/s12640-016-9690-9. Epub 2016 Dec 22.
Gray matter volume deficits have been identified in cognitively impaired patients with chronic obstructive pulmonary disease (COPD). However, it remains unknown whether the gray matter volume is altered in COPD patients with subclinical cognitive impairment. To determine whether any gray matter abnormalities are present in these patients, neuropsychological tests and structural MRI data were analyzed from 60 patients with COPD and 60 age-, gender-, education-, and handedness-matched normal controls (NCs). The COPD patients had similar Mini-Mental State Examination (MMSE) scores compared with the NCs. However, they had reduced Montreal Cognitive Assessment (MoCA) scores for visuospatial and executive and naming and memory functions (P < 0.001). Voxel-based morphometry (VBM) analysis revealed that the COPD patients had significantly lowered gray matter volumes in several brain regions, including the left precuneus (PrCU), bilateral calcarine (CAL), right superior temporal gyrus/middle temporal gyrus (STG/MTG), bilateral fusiform gyrus (FG), and right inferior parietal lobule (IPL) (P < 0.01, corrected). Importantly, the forced vital capacity (FVC) was found to be associated with the gray matter volume in the calcarine. The present study confirmed that brain structural changes were present in stable COPD patients with subclinical cognitive impairment. These findings may provide new insights into the pathogenesis of COPD.
在患有慢性阻塞性肺疾病（COPD）的认知受损患者中已发现灰质体积减少。然而，尚不清楚在具有亚临床认知障碍的COPD患者中灰质体积是否发生改变。为了确定这些患者是否存在任何灰质异常，对60例COPD患者和60例年龄、性别、教育程度和利手匹配的正常对照（NC）进行了神经心理学测试和结构MRI数据分析。与NC相比，COPD患者的简易精神状态检查表（MMSE）得分相似。然而，他们在蒙特利尔认知评估（MoCA）中的视觉空间、执行、命名和记忆功能得分降低（P < 0.001）。基于体素的形态学测量（VBM）分析显示，COPD患者在几个脑区的灰质体积显著降低，包括左侧楔前叶（PrCU）、双侧距状裂（CAL）、右侧颞上回/颞中回（STG/MTG）、双侧梭状回（FG）和右侧顶下小叶（IPL）（P < 0.01，校正后）。重要的是，发现用力肺活量（FVC）与距状裂的灰质体积相关。本研究证实，在具有亚临床认知障碍的稳定COPD患者中存在脑结构变化。这些发现可能为COPD的发病机制提供新的见解。
