Cerebral cortical dysfunction in chronic obstructive pulmonary disease: role of transcranial magnetic stimulation.
METHODS
Chest and Neurology Departments, Assiut and Al-Azhar University Hospitals, Egypt.


OBJECTIVE
To study a large population with respect to previous preliminary data, using transcranial magnetic stimulation (TMS) as a prognostic method for evaluation of cerebral cortical functions during acute exacerbation of chronic obstructive pulmonary disease (AE-COPD).


METHODS
In a case-control study, 41 patients with AE-COPD and 30 healthy controls were included. For all, TMS was used to assess corticospinal pathway function and cortical excitability.


RESULTS
Patients demonstrated increased motor threshold (resting and active), central motor conduction time and increased cortical silent period. Significant correlation was identified between TMS parameters and pulmonary function tests (forced vital capacity, forced expiratory volume 1%, forced expiratory volume in one second) and arterial blood gases (pH, paO(2) and HCO(3)), serum chloride and potassium.


CONCLUSIONS
These results indicate that the motor cortex is less excitable during AE-COPD. This is attributed to reduction of cortical excitability due to chronic hypoxaemia. Therefore, early detection of cerebral changes might be in accordance with the importance of early O(2) therapy in reducing morbidity and mechanical ventilation dependency in COPD. This opens discussion for future early therapeutic use of GABAergic and glutaminergic modulating drugs with oxygen to protect the brains of COPD patients.
Mohamed-Hussein
A A R
AA
Department of Chest, Assiut University Hospital, Assiut, Egypt. massah_99@yahoo.com
Hamed
S A
SA
Abdel-Hakim
N
N
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology*; D019054:Evoked Potentials, Motor / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation; D014882:Water-Electrolyte Balance