Bidirectional cortical gyrification alterations in chronic obstructive pulmonary disease: links to cognitive impairment and global initiative for chronic obstructive lung disease staging.

PURPOSE: Cognitive impairment is a common but poorly understood comorbidity in chronic obstructive pulmonary disease (COPD). Although gray matter abnormalities have been observed in this population, the contribution of cortical gyrification-a structural feature linked to cognitive development and brain plasticity-remains unclear. This study aimed to characterize region-specific cortical gyrification alterations and examine their associations with domain-specific cognitive function and disease severity.

METHODS

We enrolled 59 patients with stable COPD and 49 healthy controls who underwent pulmonary function testing, Montreal Cognitive Assessment, and high-resolution T1WI. The Toro's Gyrification Index quantified cortical gyrification. Group comparisons, partial correlations, and multiple linear regression analyses were conducted with adjustments for age, sex, and total intracranial volume.

RESULTS

Compared with healthy controls, the patient group showed increased Toro's Gyrification Index in the bilateral superior temporal gyrus and left insula, and decreased values in the bilateral lingual gyri (P < .05). In the patient group, Toro's Gyrification Index in the left superior temporal gyrus was negatively correlated with abstract thinking (r = - .46, P = .003) and attention scores (r = - .39, P = .01). A regression model incorporating Toro's Gyrification Index in the left superior temporal and right lingual gyri explained 31% of the variance in abstract thinking score (F = 3.68, P = .004). The Global Initiative for Chronic Obstructive Lung Disease stage significantly predicted the right superior temporal gyrus Toro's Gyrification Index (F = 3.98, P = .002), with higher values observed in patients with disease stages 3 and 4 than stages 1 and 2 (F = 4.74, P = .005).

CONCLUSIONS

COPD is associated with region-specific, bidirectional cortical gyrification changes that are closely linked to cognitive impairment and disease severity. These findings suggest that gyrification-based metrics may offer a novel neuroimaging perspective for understanding brain reorganization in COPD.

CLINICAL TRIAL NUMBER: Not applicable.