Improved neurobehavioral functioning in emphysema patients following medical therapy.
OBJECTIVE
To evaluate the neuropsychological and psychological functioning of emphysema patients following 10 weeks of multidisciplinary medical therapy (MT).


METHODS
Patients with moderate to severe emphysema (n = 56) enrolled in the National Emphysema Treatment Trial at 2 sites (National Jewish Health and Ohio State University) completed cognitive, psychological, and quality-of-life (QOL) tests at baseline and 6 to 10 weeks following participation in pulmonary rehabilitation. Healthy control subjects (matched on age, sex, race, and education, n = 54) completed the same tests at baseline and 6 to 10 weeks later.


RESULTS
Controlling for practice effects and educational level, emphysema patients in the MT group demonstrated significant improvement compared with controls on a global index of cognition, and in measures of visuomotor sequential skills and visual memory. The MT group showed significant reductions in several measures of depression and anxiety, and the control group showed a significant reduction in total depression, but acute anxiety scores were worse 6 to 10 weeks later. The MT group showed significant improvement on 6 of 9 QOL variables and no change was detected in the control group. Improvement on the cognitive index score in the mt group was related to decline in depression and increased workload.


CONCLUSIONS
emphysema patients who received MT demonstrated improvement in specific neuropsychological functions, depression, anxiety, and QOL scores compared with control subjects during the same interval (with no treatment). Mechanisms for these neurobehavioral changes include greater exercise endurance and decreased depression.
Kozora
Elizabeth
E
National Jewish Health, Denver, Colorado 80206, USA. kozorae@NJH.org
Emery
Charles F
CF
Zhang
Lening
L
Make
Barry
B
D001007:Anxiety / Q000523:psychology*; D016022:Case-Control Studies; D003071:Cognition; D003863:Depression / Q000523:psychology*; D004646:Emphysema / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008568:Memory; D008875:Middle Aged; D053580:Muscle Strength; D009483:Neuropsychological Tests; D010807:Physical Endurance; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index