Department of Radiology, the First Affiliated Hospital of Nanchang University, No.17, Yongwai Zheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, People's Republic of China.
Department of Respiratory, the First Affiliated Hospital of Nanchang University, Nanchang, China.
Brain Imaging Behav. 2020 Apr;14(2):573-585. doi: 10.1007/s11682-019-00130-7.
Chronic obstructive pulmonary disease (COPD) affects a large population and is closely associated with cognitive impairment. However, the mechanisms of cognitive impairment in COPD patients have not been unraveled. This study investigated the change in patterns of intrinsic functional hubs using a degree centrality (DC) analysis. The connectivity between these abnormal hubs with the remaining brain was also investigated using functional connectivity (FC). Nineteen stable patients with COPD and 20 normal controls(NC) underwent functional magnetic resonance imaging (MRI) examinations and clinical and neuropsychologic assessments. We measured the voxel-wise DC across the whole brain gray matter and the seed-based FC between these abnormal hubs in the remaining brain matter; the group difference was calculated. A partial correlation analysis was performed to assess the relationship between the abnormal DC and clinical variables in COPD patients. Compared to NC, the patients with COPD exhibited significantly decreased DC in the right lingual gyrus (LG), bilateral supplementary motor area (SMA), and right paracentral lobule (PCL). A further seed-based FC analysis found that COPD patients demonstrated significantly decreased FC between these abnormal hubs in several brain areas, including the left cerebellum anterior lobe, left lingual gyrus, left fusiform gyrus, right insula, right inferior frontal gyrus, limbic lobe, cingulate gyrus, left putamen, lentiform nucleus, right precuneus, and right paracentral lobule. A partial correlation analysis showed that the decreased DC in the right PCL was positively correlated with the FEV1 and FEV1/FVC, and the decreased DC in the SMA was positively correlated with naming and pH in COPD patients. This study demonstrates that there are intrinsic functional hubs and connectivity alterations that may reflect the aberrant information communication in the brain of COPD patients. These findings may help provide new insight for understanding the mechanisms of COPD-related cognitive impairment from whole brain functional connections.
慢性阻塞性肺疾病（COPD）影响着庞大的人群，且与认知障碍密切相关。然而，COPD 患者认知障碍的机制尚未被揭示。本研究使用度中心度（DC）分析来研究内在功能中枢的模式变化。还使用功能连接（FC）研究了这些异常中枢与剩余大脑之间的连接。19 名稳定的 COPD 患者和 20 名正常对照（NC）接受了功能磁共振成像（MRI）检查和临床及神经心理学评估。我们测量了全脑灰质的体素级 DC 和剩余脑内这些异常中枢之间的基于种子的 FC；计算了组间差异。进行偏相关分析以评估 COPD 患者异常 DC 与临床变量之间的关系。与 NC 相比，COPD 患者的右侧舌回（LG）、双侧辅助运动区（SMA）和右侧旁中央小叶（PCL）的 DC 显著降低。进一步的基于种子的 FC 分析发现，COPD 患者在几个脑区之间的 FC 显著降低，包括左侧小脑前叶、左侧舌回、左侧梭状回、右侧岛叶、右侧额下回、边缘叶、扣带回、左侧壳核、豆状核、右侧楔前叶和右侧旁中央小叶。偏相关分析显示，右侧 PCL 的 DC 降低与 FEV1 和 FEV1/FVC 呈正相关，SMA 的 DC 降低与 COPD 患者的命名和 pH 值呈正相关。本研究表明，存在内在功能中枢和连接改变，可能反映了 COPD 患者大脑中异常的信息传递。这些发现可能有助于从全脑功能连接的角度为理解 COPD 相关认知障碍的机制提供新的见解。
