Abstract
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.
Highlights
Previous studies have confirmed that degree centrality (DC) has a high sensitivity, specificity, and test-retest reliability,(Zuo and Xing 2014) and it has been increasingly used in many disorders associated with cognitive impairment, such as obstructive sleep apnea, diabetes, Parkinson’s, and Alzheimer’s disease.(Li et al 2016; Liu et al 2018; Wang et al 2018; Guo et al 2016) the voxel-wise DC can help us investigate the intrinsic function hubs that may be associated with cognitive impairment in Chronic obstructive pulmonary disease (COPD)
According to the GOLD manual, the subjects with a forced expiratory volume in 1 s (FEV1)/forced expiratory vital capacity (FVC) < 0.7 and FEV1 ≥ 80% predicted were classified as mild COPD, those with 50% ≤ FEV1 < 80% predicted were classified as moderate COPD, those with 30 ≤ FEV1 < 50% predicted were classified as severe COPD and those with FEV1 < 30% predicted were classified as extremely severe COPD
We further examined the seed-based functional connectivity (FC) associated with 3 region of interest (ROI) that exhibited reduced DC in the patients with COPD compared to normal controls (NC)
Summary
Many previous studies have confirmed that patients with COPD display structural changes and metabolic abnormalities in local functions; these changes can be observed in specific brain regions using advanced neuroimaging techniques. Previous studies have confirmed that DC has a high sensitivity, specificity, and test-retest reliability,(Zuo and Xing 2014) and it has been increasingly used in many disorders associated with cognitive impairment, such as obstructive sleep apnea, diabetes, Parkinson’s, and Alzheimer’s disease.(Li et al 2016; Liu et al 2018; Wang et al 2018; Guo et al 2016) the voxel-wise DC can help us investigate the intrinsic function hubs that may be associated with cognitive impairment in COPD
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