Proton magnetic resonance spectroscopy of brain to study the cerebral metabolic abnormalities in COPD patients: a case control study in north India.

Background. To investigate changes in the cerebral metabolism of nondiabetic and normolipidaemic patients with chronic obstructive pulmonary disease (COPD) using localised in vivo proton magnetic resonance spectroscopy ( 1 H MRS), and to correlate these with the severity of disease. Methods. Twenty-eight symptomatic COPD patients and 19 healthy controls underwent 1 H MRS of brain, pulmonary function testing and respiratory muscle strength evaluation. The parieto-temporal and occipital regions were localised for 1 H MRS. The metabolic ratios of N-acetyl aspartate to cretinine (NAA/Cr) and choline containing compound to creatinine (Cho/Cr) were calculated by integrating area under the each peak. Results. The mean value of NAA/Cr and Cho/Cr in parieto-temporal area in COPD patients were (1.86±0.54) and (0.77±0.23), respectively. The mean values of NAA/Cr and Cho/Cr in occipital area in COPD patients were (1.75±0.44) and (0.61±0.25), respectively. Compared with healthy control subjects, the mean values of Cho/Cr in COPD patients were lower, both in parieto-temporal (0.77±0.23 vs 0.89±0.35; p=0.17) and occipital (0.61±0.25±vs0.67±0.08; p = 0.36) areas of the brain. Conclusions. The cerebral metabolism, pulmonary function testing and respiratory muscle strength altered in symptomatic COPD patients. The clinical significance of cerebral metabolic changes in COPD patients needs to be further investigated. [Indian J Chest Dis Allied Sci 2009;51:15-19]