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Cerebral metabolism altered in COPD patients

By Michelle Beaulieu Cooke

WESTPORT, CT (Reuters Health) – Korean scientists have discovered significant cerebral metabolic abnormalities in patients with chronic obstructive pulmonary disease (COPD).

"Others have reported that cognitive deficits are found in COPD patients, and that these neuropsychological dysfunctions are related to impaired pulmonary function or arterial blood gas analysis parameters," study director Dr. Tae Sun Shim, of the University of Ulsan College of Medicine, Seoul, Korea, told Reuters Health.

But he explained that the new report is "the first demonstration of cerebral metabolism being significantly altered in symptomatic COPD patients."

Dr. Shim and colleagues examined cerebral metabolism in 17 COPD patients and 21 age-matched, healthy controls using magnetic resonance spectroscopy. All patients also took a battery of neuropsychological, tests including the Wechsler memory scale-revised, the color trail test and the grooved pegboard test.

Levels of N-acetyl aspartate, creatine and choline in parietal white matter were all significantly lower in COPD patients than in controls (p < 0.0125), the research team reports in the November issue of Chest.

Scores on all neuropsychological tests were significantly lower in COPD patients compared with standardized values, but the scores were not correlated with levels of cerebral metabolites. The only exception to this finding was a significant positive association between scores on the Wechsler memory scale-revised and levels of choline in parietal white matter in COPD patients (p < 0.05).

The investigators could not identify any correlation between measures of cerebral metabolism and physiologic parameters in COPD patients, such as pulmonary function.

Dr. Shim said that hypoxemia may be one cause of cerebral metabolic dysfunction. "Even though the patients in this study don't have hypoxemia in the resting state, they would have hypoxemic events during sleep or during activities of daily living," he pointed out. Smoking itself might be a factor, he said, but the team found no cerebral metabolic differences between smokers and nonsmokers.

Chest 2001;120:1506-1513.

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