Homogenous Functional Connection Of Stable Chronic Obstructive Pulmonary Disease:a Resting-state FMRI Study

Objective:This study used the method of voxel-mirrored homotopic connectivity（VMHC）to explore the coordinated changes in bilateral brain function in patients with chronic obstructive pulmonary disease（COPD）,thereby understanding possible pathophysi-ological evidence of the pathogenesis of cognitive impairment in patients with COPD.Materials and methods:The research group recruited 19 stable COPD patients（an average age of 62.7±5.9 year）and 20 healthy control groups（an average age of 60.8±6.3 year）matched with their age,gender and number of years of education by the department of aspiration in the First Affiliated Hospital of Nanchang University.Subjects in both groups underwent resting functional magnetic resonance imaging（f MRI）,arterial blood gas analysis,pulmonary function detection and neurocognitive assessment.The resting-state f MRI image is obtained after preprocessing and VMHC calculation The VMHC values of whole brain voxels were obtained by statistical analysis and calculation.Obtain the abnormal VMHC value brain regions between COPDs group and HCs group through statistical analysis operation.Then the abnormal brain regions were selected as seed points to analyze the functional connections of the whole brain.Finally,evaluate the correlation between the brain regions with altered functional connection coefficient and the arterial blood gas analysis,lung function index and cognitive function score in COPD patients.Results:（1）Pa O₂（P<0.001）,Sa O₂（P=0.008）,FVC（P<0.001）,FEV₁（P<0.001）,and FEV₁/FVC（P<0.001）in COPD patients were significantly lower than that in the HC group,while Pa CO₂ was higher than that in the HC group（P<0.001）.The total scores of COPD patients in the Mo CA（P<0.001）cognitive assessment scales was lower than those in the HC group,and the scores in the Mo CA scale naming（P=0.026）,visual space and execution（P=0.012）and memory tests（P<0.001）were also lower than those in the HC group.（2）Compared with the healthy control group,the VMHC value of bilateral superior temporal gyrus of COPD patients were significantly reduced,and no higher VMHC value was detected.（3）The functional connection analysis using the abnormal VMHC value brain area as the seed point shows that there are abnormal functional connections between the superior temporal gyrus and several brain regions of the whole brain in patients with COPD.（4）Correlation analysis showed that the functional connectivity coefficient between the superior temporal gyrus and several brain regions was positively correlated with FEV₁,Sa O₂,and negatively correlated with Pa CO₂,the total Mo CA score,language,abstract,memory.Conclusion:There are abnormal functional coordination between bilateral hemispheres and abnormal functional connectivity of multiple brain regions in stable COPD patients,and the functional connectivity abnormalities correlated with lung function index,arterial blood gas analysis and cognitive function score,which might provide new pathophysiological evidence for further understanding the potential mechanism of cognitive impairment in COPD patients.