Association between airflow limitation and leukoaraiosis of the brain

Respir Investig. 2021 May;59(3):320-326. doi: 10.1016/j.resinv.2020.11.004. Epub 2020 Dec 11.

Abstract

Background: Patients with chronic obstructive pulmonary disease (COPD) have several comorbidities. Leukoaraiosis (LA) is an abnormal appearance of brain white matter on neuroimaging, and it has been linked to microangiopathy of the brain. In this study, we explored the association between airflow limitation (AL) and LA volume and localization.

Methods: This observational cross-sectional study included 3,945 subjects who underwent medical check-ups between January 2015 and December 2017. LA was automatically assessed and quantified on brain MRI images using a morphometric program. Spirometry without bronchodilator was performed, and AL was defined as the ratio of forced expiratory volume in 1 s/forced vital capacity <0.70.

Results: In the multivariate analysis, AL was an independent predictor of LA volume (t = 3.06, P < 0.01), in addition to age, hypertension, and dyslipidemia. Compared with the propensity-matched subjects without AL, the subjects with AL (n = 157) had significantly higher LA volumes (4.65 cm3 vs. 3.26 cm3, P < 0.05) and frequency of LA in the frontal lobe, but not in the parietal, temporal, and occipital lobes.

Conclusions: Our findings suggest that AL is associated with increased LA volume and with more frequent localization of LA in the frontal lobe.

Keywords: Airflow limitation; Chronic obstructive pulmonary disease; Leukoaraiosis; White matter hyperintensity.

MeSH terms

  • Aged
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume*
  • Frontal Lobe / diagnostic imaging
  • Frontal Lobe / pathology
  • Humans
  • Leukoaraiosis / diagnostic imaging
  • Leukoaraiosis / epidemiology
  • Leukoaraiosis / pathology*
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / pathology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Spirometry
  • Vital Capacity*
  • White Matter / diagnostic imaging
  • White Matter / pathology*