PT - JOURNAL ARTICLE AU - Charlotte Claire Savage AU - Piers Henry Anderson Dixey AU - Catherine Pennington AU - James W Dodd TI - Visual rating assessment of cerebral atrophy and its relationship with cognitive function in chronic obstructive pulmonary disease AID - 10.1136/bmjresp-2018-000310 DP - 2018 Nov 01 TA - BMJ Open Respiratory Research PG - e000310 VI - 5 IP - 1 4099 - http://bmjopenrespres.bmj.com/content/5/1/e000310.short 4100 - http://bmjopenrespres.bmj.com/content/5/1/e000310.full SO - BMJ Open Resp Res2018 Nov 01; 5 AB - Introduction Widespread white matter damage and cognitive impairment have been demonstrated in chronic obstructive pulmonary disease (COPD). However, it remains unclear if brain atrophy is a global phenomenon or if specific subregions are differentially affected. The aims of this study are, first, to test a simple, validated visual analogue grading technique. Second, we hypothesised that frontal regions of the brains of patients with COPD will show greater signs of atrophy compared with control subjects. Third, any localised regions of atrophy would correlate with components of cognitive performance. Finally, the severity of cerebral atrophy would be associated with measures of respiratory disease severity.Methods We used a simple, validated visual analogue grading technique to assess the degree of regional atrophy in multiple brain regions from cerebral MR images in patients with stable non-hypoxaemic COPD (n=25) and age-matched control subjects (n=25). We also explored correlations between regional brain atrophy with demographics, cognitive performance measures and disease severity. Measures of cognitive performance focused on executive function, working memory, verbal memory, overall memory and processing speed. Measures of disease severity include lung function, gas exchange, health status and breathlessness questionnaires.Results The visual grading scale found that patients with COPD had significantly greater frontal atrophy than control subjects (p=0.02), independent of smoking history, comorbid depression or anxiety. Cognitive function was significantly worse in the COPD group for executive function (p<0.001), working memory (p=0.02), verbal memory (p=0.03) and processing speed (p=0.001). Group differences in atrophy did not appear to account for differences in cognitive function. We were unable to identify meaningful correlations between regional atrophy and disease severity or cognitive function.Conclusion Further work is needed to identify causative mechanisms behind unexplained structural brain changes in COPD.