New research revealed structural alterations in the cortex, hippocampus, and amygdala regions of the brain in individuals with Chronic Obstructive Pulmonary Disease. The study entitled “Structural Brain Changes in Patients with Chronic Obstructive Pulmonary Disease” was published this July in Chest.
Chronic Obstructive Pulmonary Disease (COPD) is a wide designation that includes various progressive lung conditions like emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. COPD is characterized generally by increasing breathing difficulty. For this condition, the frequent use of inhaled corticosteroids as a form of therapy has been questioned by researchers. Additionally, COPD is frequently associated with disease-specific fears and avoidance of physical activity. However, structural brain changes in individuals with COPD and its relation to disease duration and disease-specific fears is not well understood.
The research team studied structural brain changes in individuals with COPD and their relation with disease duration, fear of dyspnea, and fear of physical activity. They analyzed and quantified differences in widespread cortical degeneration and regional gray matter in 30 patients with moderate-to-severe COPD and 30 matched healthy control individuals using voxel-based morphometric analysis of MRI images. The researchers also used the COPD anxiety questionnaire to evaluate the Disease-associated fears.
After whole brain analysis, is was observed that COPD patients had no general cortical degeneration but showed decreased gray matter in several cortex regions (posterior, anterior and mid cingulate), as well as the hippocampus, and amygdala. The researchers observed a negative association between disease duration and reduced gray matter of the anterior cingulate and this was mediated by fear of physical activity. The brain regions affected are very important for the processing of dyspnea, fear and sensitivity to pain (nociception).
The researchers concluded that the structural brain changes observed were partly associated with longer disease period and more disease-specific fears. These structural changes of the brain may lead to worse outcomes of COPD. The research team highlighted the need for further research on this subject such as longitudinal designs and objective measures of physical activity, like activity monitors, are necessary for a better understanding and to give additional insights about the dynamics of gray matter volume changes in relation to activity avoidance in COPD.