COPD
Conditions
Keywords
COPD, Cognitive Function, MRI Brain, Aortic Stiffness, Cerebrovascular disease
Brief summary
Cognitive impairment is a known consequence of cerebral small-vessel disease. Moderate to severe cognitive impairment has been shown in up to 60% of certain individuals with COPD and is likely to profoundly influence an individual's ability to manage their disease. In addition to cerebral small vessel damage and cognitive dysfunction, other organs such as the heart, kidneys, and retina are likely to be susceptible to small-vessel damage in COPD. Several large population studies have shown that COPD is a significant independent risk factor for myocardial infarction, with the effect most marked in early, mild disease. We propose to compare non-invasive MR brain imaging of white matter microstructure (diffusion tensor), cerebral perfusion (arterial spin labelling) and accumulated cerebral small vessel disease (cerebral microbleeds), in COPD patients to smokers without COPD. In addition we plan to explore mechanisms of cerebral small vessel disease in COPD by looking for associations between arterial stiffness, end organ vascular damage and cognitive function.
Interventions
None listed
Sponsors
North Bristol NHS Trust
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
40 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
1. Subjects must give their signed and dated written informed consent 2. Subjects must be aged \>40 and ≤ 85 3. Subjects with a smoking history \> 10 pack years. 4. COPD group: Subjects with a FEV/FVC \<70%
Exclusion criteria
1. Resting oxygen saturations \<92% on room air. 2. Long term oxygen therapy 3. Recent exacerbation of COPD (4 weeks) 4. Ischaemic heart disease 5. Cerebrovascular disease 6. Uncontrolled hypertension 7. Diabetes mellitus 8. Hepatic failure 9. Neurological disease 10. Non-cured tumours 11. Obstructive sleep apnoea 12. Current of past alcohol/drug abuse 13. Known history of dementia 14. Visual or hearing impairment that precludes neuropsychological assessment 15. Neuropsychological tests undertaken outside the study 16. Pregnant women or women who are lactating 17. Known alpha 1 anti-trypsin deficiency as a cause of their COPD 18. History of psychiatric disorders, or other conditions that will impact on the validity of their consent or interfere with compliance to perform study procedures. 19. Contra indication to MRI scanning -
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fractional Anisotropy | upto 4 weeks | MRI Diffusion Imaging - measure of cerebral white matter microstructure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| MRI Cerebral Perfusion - ASL | upto 4 weeks | — |
| Cerebral Microbleeds | upto 4 weeks | — |
| Cognitive Function | upto 4 weeks | Montreal Cognitive Assessment |
| Cardiac MRI | upto 4 weeks | LV & RV Mass |
| FEV1 % predicted | upto 4 weeks | — |
| Aortic Pulse Wave Velocity | upto 4 weeks | Aortic stiffness |
| Retinal Photography | upto 4 weeks | Retinal Arterial Narrowing |
| Micro-albuminuria | upto 4 weeks | Spot urine albumin sample mg/l (milligram albumin per litre of urine) |
| Health Status | upto 4 weeks | COPD Assessment Test (CAT score) 0-40 |
| Arterial Oxygen Saturation | upto 4 weeks | — |
Other
| Measure | Time frame | Description |
|---|---|---|
| Serum Inflammatory Markers | upto 4 weeks | Fibrinogen, C reacive Protein, IL-6 |
Countries
United Kingdom
Outcome results
None listed