title: Reduced cortical thickness, surface area in patients with chronic obstructive pulmonary disease: a surface-based morphometry and neuropsychological study.
abstract: Neural impairments accompanying chronic obstructive pulmonary disease (COPD) have received growing research attention. Previous neuroimaging studies exclusively used volumetric methods to measure cortical volume as a whole rather than focusing on anatomical and neuropathological distinct indices. Here we decomposed the cortical architecture into cortical thickness (CTh), surface area (SA), and gyrification, for the first time, to provide a more integrative profile of brain damage in COPD. Clinical T1-weighted MRI scans were acquired in 25 stable COPD patients (mean age 69) and 25 age-matched controls. Images were processed using surface-based morphometry to obtain cortical parameters enabling more accurate measurement in deep sulci and localized regional mapping. Demographic, physiological, and cognitive assessments were made and correlated with cortical indices. Compared to controls, COPD patients showed significantly reduced CTh broadly distributed in motor, parietal, and prefrontal cortices, together with more circumscribed SA reduction in dorsomedial prefrontal cortex and Broca's area (cluster-level P < 0.05 corrected). No abnormal gyrification was detected. Decreased CTh in parietofrontal networks strongly correlated with visuospatial construction impairment in COPD patients. Furthermore, thinner dorsolateral prefrontal cortex (DLPFC) best predicted poorer performance (r (2)  = 0.315, P = 0.004), and was associated with lower arterial oxygen saturation. These data indicate that cortical thinning is a key morphologic feature associated with COPD that could be partly attributed to oxygen desaturation and contributes to COPD visual memory and drawing deficits. Surface-based morphometry provides valuable information concerning COPD, and could ultimately help us to characterize the neurodegenerative pattern and to clarify neurologic mechanisms underlying cognitive dysfunction in COPD patients.
authors.affiliation: Department of Physiology and Neurobiology, Medical College of Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.|Center for Molecular Imaging and Translational Medicine, School of Public Health, Xiamen University, Xiamen, China.
authors.forename: In-Tsang
authors.initials: IT
authors.lastname: Lin
authors.affiliation: Department of Physiology and Neurobiology, Medical College of Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Magnetic Resonance Center, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Respiratory Medicine, Zhongshan Hospital, Medical College of Xiamen University, Xiamen, China.
authors.forename: Shili
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Department of Cognitive Sciences, Institute of Basic Medical Sciences, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Fan
authors.affiliation: Department of Physiology and Neurobiology, Medical College of Xiamen University, Xiang'an South Road, Xiamen, 361102, China. zhangjiaxing.dpn@hotmail.com.
authors.forename: Jiaxing
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D002540:Cerebral Cortex / Q000033:anatomy & histology / Q000503:physiopathology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000473:pathology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D017397:Prefrontal Cortex / Q000033:anatomy & histology / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*
keywords: Chronic obstructive pulmonary disease; Cortical thinning; Hypoxia; MRI; Surface-based morphometry; Visuospatial deficits