Abnormal Brain Functional Connectivity in Patients with Chronic Obstructive Pulmonary Disease and Correlations with Clinical and Cognitive Parameters

Kyung-Il Han,1,* Yoomi Yeo,2,* Hang Joon Jo,3,4,* Min Ju Jo,5 Yeonkyung Park,6 Tai Sun Park,2 Sung Jun Jung,3,4 Jin Ho Bae,4 Sung-Ho Jang,7 Joonho Choi,8 Dong Woo Park,9 Tae-Hyung Kim2 1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Korea; 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea; 3Department of Physiology, Hanyang University College of Medicine, Seoul, Korea; 4Department of Biomedical Engineering, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, Korea; 5Department of Internal Medicine, Myongji St. Mary’s Hospital, Seoul, Korea; 6Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea; 7Department of Rehabilitation, College of Medicine, Hanyang University Guri Hospital, Guri, Korea; 8Department of Psychiatry, College of Medicine, Hanyang University Guri Hospital, Guri, Korea; 9Department of Radiology, College of Medicine, Hanyang University Guri Hospital, Guri, Korea*These authors contributed equally to this workCorrespondence: Tae-Hyung Kim, Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, 153, Gyeongchun-ro, Guri-si, Gyeonggi-do, 11923, Korea, Tel +82-31-560-2243, Fax +82-31-553-7369, Email [email protected]: Cognitive impairment is a major comorbidity of chronic obstructive pulmonary disease (COPD), but the underlying mechanisms are not fully understood. In this study, we used resting-state functional magnetic resonance imaging to investigate brain functional connectivity (FC) abnormalities in patients with COPD and explored the correlation between abnormal FC and COPD-related clinical parameters.Methods: Forty-one patients with COPD, without a definite diagnosis of cognitive impairment or depression, and 30 age- and sex-matched controls were recruited. A total of 184 resting-state functional connectivity (RSFC) maps were generated for all seed points. Welch’s t-test was used to assess differences in RSFC between the COPD and control groups, and the correlation coefficients between RSFC and clinical parameters were calculated.Results: Patients with COPD had lower scores on the Mini-Mental State Exam (MMSE) and Korean version of the Montreal Cognitive Assessment and higher scores on the Beck Depression Inventory than the control group. Additionally, patients with COPD showed decreased RSFC in the left middle-posterior cingulate cortex, left posterior-dorsal cingulate cortex, and right superior occipital gyrus and increased RSFC in the left superior temporal sulcus, left posterior transverse collateral sulcus, right occipital pole, and right precentral gyrus. The regions showing differences in FC correlated with MMSE score, COPD symptom assessment scales, such as the COPD Assessment Test and modified Medical Research Council Dyspnea Scale, and pulmonary function parameters, including forced expiratory volume in one second and forced vital capacity.Conclusion: Patients with COPD showed significant differences in FC within specific brain regions that correlated with symptoms, cognition, and lung function.Keywords: Brain functional magnetic resonance imaging, chronic obstructive pulmonary disease, resting state functional connectivity