COPD-Related Physiology and the Brain



Status:Recruiting
Conditions:Chronic Obstructive Pulmonary Disease, Cognitive Studies, Pulmonary
Therapuetic Areas:Psychiatry / Psychology, Pulmonary / Respiratory Diseases
Healthy:No
Age Range:30 - 85
Updated:4/5/2019
Start Date:May 1, 2017
End Date:August 31, 2021
Contact:Hannatu I Amaza, BS
Email:hannatu-amaza@uiowa.edu
Phone:319-384-9210

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Determinants of Altered Brain Structure and Function in Smokers With COPD-Related Lung Pathophysiology

COPD is the third leading cause of combined morbidity, disability, and mortality in the
United States and is often associated with cognitive impairment. The goal of the proposed
project is to examine novel pulmonary and vascular physiological mechanisms that contribute
to structural brain abnormalities and cognitive dysfunction early in the course of COPD. The
project will generate information to ultimately inform the development of interventions to
delay or prevent cognitive dysfunction.

Chronic Obstructive Pulmonary Disease (COPD) is the 3rd leading cause of morbidity and
mortality in the US with increasing prevalence in older adults. The impact of COPD on the
brain is an area of expanding research interest. A staggering 40-60% of patients with COPD
have cognitive impairments including deficits in executive functioning (e.g., decision
making), processing speed, and memory. Intact cognition is critical for independently
managing daily tasks (e.g., medication and money management). Since there are currently no
treatments to fully reverse cognitive impairment once it is present, preventing and delaying
onset is essential. Given the high prevalence of COPD, understanding how COPD confers an
increased risk for cognitive impairment should be a top public health priority. There is an
urgent need to identify potentially modifiable physiological characteristics of individuals
with early COPD-related pathophysiology who are at risk of developing brain abnormalities.
The earliest changes that occur in COPD are driven by an enhanced chronic inflammatory
response that includes small airway disease in the lung and vascular abnormalities.
COPD-related lung pathophysiology can be measured continuously and is separable from amount
of smoking. These physiological changes are often present in individuals who do not meet
traditional criteria for COPD diagnosis and have not yet manifested significant clinical
symptoms. We propose that chronic smokers who are susceptible to COPD and show evidence of
COPD-related lung pathophysiology on lung CT also experience vascular dysfunction
(particularly central artery stiffness) that contributes to structural brain abnormalities
and cognitive impairment. The proposed project will: 1) model the effects of novel
physiological mechanisms on the brain in COPD, 2) focus on changes in brain structure and
function early in the development of COPD by including smokers who have evidence of early
COPD-related lung pathophysiology but do not meet traditional criteria for COPD, and 3)
utilize advanced technology to assess the lung (lung CT) and brain (MRI). We will recruit
participants with existing lung CT from ongoing NIH projects to complete pulmonary and
vascular measures, cognitive assessment, and brain MRI. The project is highly
multidisciplinary and leverages unique resources at the University of Iowa including the CTSA
supported Institute for Clinical and Translational Science, the Translational Human Vascular
Physiology Lab, the Iowa Neuroimaging Consortium, and the Iowa Comprehensive Lung Imaging
Center.

Inclusion Criteria:

Age 30-85, > 8th grade education, Normal/corrected hearing and vision, English Speaker,
Ability to comfortably lie flat for 1 hour.

Exclusion Criteria:

Other concomitant respiratory disorder other than asthma (e.g., cystic fibrosis), Use of
antibiotics or steroids for a COPD exacerbation within the past month, Use of 24-hour
oxygen, Pregnancy or suspected pregnancy, Uncontrolled cancer within the last 5 years,
Radiation therapy to the chest, Lung surgery (LVRS, transplant, lobectomy), Lung cancer
known or suspected, Eye surgery in the last 3 months, Pulmonary Hypertension,
Insulin-dependent diabetes, Inability to use albuterol, Chest or abdominal surgery in the
past 3 months, Heart attack in the last 3 months, Hospitalization for any heart problem in
the past month, Prior neurological condition (e.g., stroke, epilepsy, head injury with >15
mins. loss of consciousness), Previous diagnosis of dementia or learning disability, Major
comorbid medical conditions with known cognitive effects (e.g., renal failure, HF),
Psychotic disorder, bipolar disorder, current substance use disorder other than tobacco
use, Change in psychiatric medication in last month, Claustrophobia, Metal object in body
that may interfere with neuroimaging.
We found this trial at
1
site
101 Jessup Hall
Iowa City, Iowa 52242
(319) 335-3500
Principal Investigator: Karin F Hoth, PhD
Phone: 319-384-9210
University of Iowa With just over 30,000 students, the University of Iowa is one of...
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from
Iowa City, IA
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