Reduced cortical thickness, surface area in patients with chronic obstructive pulmonary disease: a surface-based morphometry and neuropsychological study

Abstract

Neural impairments accompanying chronic obstructive pulmonary disease (COPD) have received growing research attention. Previous neuroimaging studies exclusively used volumetric methods to measure cortical volume as a whole rather than focusing on anatomical and neuropathological distinct indices. Here we decomposed the cortical architecture into cortical thickness (CTh), surface area (SA), and gyrification, for the first time, to provide a more integrative profile of brain damage in COPD. Clinical T1-weighted MRI scans were acquired in 25 stable COPD patients (mean age 69) and 25 age-matched controls. Images were processed using surface-based morphometry to obtain cortical parameters enabling more accurate measurement in deep sulci and localized regional mapping. Demographic, physiological, and cognitive assessments were made and correlated with cortical indices. Compared to controls, COPD patients showed significantly reduced CTh broadly distributed in motor, parietal, and prefrontal cortices, together with more circumscribed SA reduction in dorsomedial prefrontal cortex and Broca’s area (cluster-level P < 0.05 corrected). No abnormal gyrification was detected. Decreased CTh in parietofrontal networks strongly correlated with visuospatial construction impairment in COPD patients. Furthermore, thinner dorsolateral prefrontal cortex (DLPFC) best predicted poorer performance (r 2 = 0.315, P = 0.004), and was associated with lower arterial oxygen saturation. These data indicate that cortical thinning is a key morphologic feature associated with COPD that could be partly attributed to oxygen desaturation and contributes to COPD visual memory and drawing deficits. Surface-based morphometry provides valuable information concerning COPD, and could ultimately help us to characterize the neurodegenerative pattern and to clarify neurologic mechanisms underlying cognitive dysfunction in COPD patients.

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Acknowledgments

This work was supported by National Natural Science Foundation of China (Project No. 31071041; 81171324), Bureau of Science and Technology of Hangzhou (20090833B10) and Health Bureau of Zhejiang Province (2009A168).

Ethical standards and patient consent

We declare that all human studies have been approved by the Research Ethics Committee of Xiamen university and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflicts of interest

Ji Chen, In-Tsang Lin, Haiyan Zhang, Jianzhong Lin, Shili Zheng, Ming Fan, and Jiaxing Zhang declare that they have no conflict of interest.

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Chen, J., Lin, I., Zhang, H. et al. Reduced cortical thickness, surface area in patients with chronic obstructive pulmonary disease: a surface-based morphometry and neuropsychological study. Brain Imaging and Behavior 10, 464–476 (2016). https://doi.org/10.1007/s11682-015-9403-7

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Keywords

  • Chronic obstructive pulmonary disease
  • Surface-based morphometry
  • Cortical thinning
  • Visuospatial deficits
  • MRI
  • Hypoxia