Disruption of white matter connectivity in chronic obstructive pulmonary disease


Autoři: Catherine A. Spilling aff001;  Paul W. Jones aff002;  James W. Dodd aff003;  Thomas R. Barrick aff001
Působiště autorů: Neuroscience Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, Tooting, London, United Kingdom aff001;  Institute of Infection and Immunity, St George's, University of London, Tooting, London, United Kingdom aff002;  Academic Respiratory Unit, Second Floor, Learning and Research, Southmead Hospital, University of Bristol, Westbury-on-Trym, Bristol, United Kingdom aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223297

Souhrn

Background

Mild cognitive impairment is a common systemic manifestation of chronic obstructive pulmonary disease (COPD). However, its pathophysiological origins are not understood. Since, cognitive function relies on efficient communication between distributed cortical and subcortical regions, we investigated whether people with COPD have disruption in white matter connectivity.

Methods

Structural networks were constructed for 30 COPD patients (aged 54–84 years, 57% male, FEV1 52.5% pred.) and 23 controls (aged 51–81 years, 48% Male). Networks comprised 90 grey matter regions (nodes) interconnected by white mater fibre tracts traced using deterministic tractography (edges). Edges were weighted by the number of streamlines adjusted for a) streamline length and b) end-node volume. White matter connectivity was quantified using global and nodal graph metrics which characterised the networks connection density, connection strength, segregation, integration, nodal influence and small-worldness. Between-group differences in white matter connectivity and within-group associations with cognitive function and disease severity were tested.

Results

COPD patients’ brain networks had significantly lower global connection strength (p = 0.03) and connection density (p = 0.04). There was a trend towards COPD patients having a reduction in nodal connection density and connection strength across the majority of network nodes but this only reached significance for connection density in the right superior temporal gyrus (p = 0.02) and did not survive correction for end-node volume. There were no other significant global or nodal network differences or within-group associations with disease severity or cognitive function.

Conclusion

COPD brain networks show evidence of damage compared to controls with a reduced number and strength of connections. This loss of connectivity was not sufficient to disrupt the overall efficiency of network organisation, suggesting that it has redundant capacity that makes it resilient to damage, which may explain why cognitive dysfunction is not severe. This might also explain why no direct relationships could be found with cognitive measures. Smoking and hypertension are known to have deleterious effects on the brain. These confounding effects could not be excluded.

Klíčová slova:

Central nervous system – Cognition – Cognitive impairment – Diffusion tensor imaging – Chronic obstructive pulmonary disease – Network analysis – Neural networks – Tractography


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