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

Abstract

Background: 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 COPDrelated 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.