Xin Huizhen, Li Haijun, Yu Honghui, Yu Jingjing, Zhang Juan, Wang Wenjing, Peng Dechang
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China,
Department of Respiratory, The First Affiliated Hospital, Nanchang University, Nanchang, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2019 Feb 27;14:499-508. doi: 10.2147/COPD.S190671. eCollection 2019.
Abnormal brain structure and function in COPD has been reported on MRI. However, the deficit in local synchronization of spontaneous activity in patients with stable COPD remains unknown. The main aim of the present study was to explore spontaneous brain activity in patients with COPD compared with normal controls using the regional homogeneity (ReHo) method based on resting-state functional MRI.
Nineteen patients with stable COPD and 20 well-matched (including age, sex, and number of years of education) normal controls who were recruited for the present study underwent resting-state functional MRI examinations and a series of neuropsychological and clinical assessments. The ReHo method was used to assess the strength of local brain signal synchrony. The mean ReHo values in brain areas with abnormal ReHo were evaluated with a receiver operating characteristic curve. The relationships between the brain regions with altered ReHo values and the clinical and neuropsychological parameters in COPD patients were assessed using Pearson's correlation.
Patients with COPD showed significantly lower ReHo values in the left occipital lobe and the right lingual, bilateral precuneus, and right precentral gyrus. The result of receiver operating characteristic curve analysis showed that the altered average ReHo values have high efficacy for distinguishing function. The mean lower ReHo values in the precuneus gyrus showed a significant positive correlation with FEV%, FEV/FVC, and orientation function but a significant negative correlation with arterial partial pressure of carbon dioxide.
The COPD patients demonstrated abnormal synchrony of regional spontaneous activity, and the regions with abnormal activity were all correlated with visual processing pathways, which might provide us with a new perspective to further understand the underlying pathophysiology of cognitive impairment in patients with COPD.
MRI已报道慢性阻塞性肺疾病（COPD）患者存在脑结构和功能异常。然而，稳定期COPD患者自发活动的局部同步性缺陷仍不清楚。本研究的主要目的是基于静息态功能MRI，采用局部一致性（ReHo）方法，探讨COPD患者与正常对照者的自发脑活动。
本研究招募了19例稳定期COPD患者和20例匹配良好（包括年龄、性别和受教育年限）的正常对照者，进行静息态功能MRI检查以及一系列神经心理学和临床评估。采用ReHo方法评估局部脑信号同步性强度。用受试者工作特征曲线评估ReHo异常脑区的平均ReHo值。采用Pearson相关性分析评估COPD患者中ReHo值改变的脑区与临床及神经心理学参数之间的关系。
COPD患者在左侧枕叶、右侧舌回、双侧楔前叶和右侧中央前回的ReHo值显著降低。受试者工作特征曲线分析结果显示，改变的平均ReHo值对鉴别功能具有较高的效能。楔前叶较低的平均ReHo值与第1秒用力呼气容积（FEV%）、FEV与用力肺活量（FVC）比值以及定向功能呈显著正相关，但与动脉血二氧化碳分压呈显著负相关。
COPD患者表现出区域自发活动的异常同步性，且活动异常的区域均与视觉处理通路相关，这可能为我们进一步理解COPD患者认知障碍的潜在病理生理学提供新的视角。
