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Event Related Potentials (P300) Based Assessment of Cognitive Functions in COPD Patients With Frequent Acute Exacerbations vs Infrequent Acute Exacerbations FREE TO VIEW

Dipti Agarwal, MD; Sushma Sood, MD; Prem Parkash Gupta, MD
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Department of Physiology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India

Chest. 2014;146(4_MeetingAbstracts):22A. doi:10.1378/chest.1987878
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SESSION TITLE: COPD Diagnosis and Evaluation Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: To assess cognitive functions using an electrophysiological tool, P300, in COPD patients with frequent acute exacerbations and to compare with cognitive functions in COPD patients who had infrequent acute exacerbations.

METHODS: We included 92 eligible COPD patients attending a COPD Clinic at a tertiary level medical college hospital and diagnosed as per GOLD guidelines. These patients were divided into 2 groups on the basis of exacerbations during preceding one year: Group 1 (FECOPD Group) included 48 patients who had ≥ 2 acute exacerbations, and Group 2 (I-FECOPD Group) included 44 patients with < 2 acute exacerbations. To assess cognitive functions event related potential, P300 was used. We used oddball paradigm, acoustic stimuli were presented by tone burst method; randomly delivering rare stimulus during the presentation of other frequent stimuli. P300 latency and amplitude were analyzed as study variables.

RESULTS: The mean age of patients in FECOPD group and I-FECOPD group was 62.58±9.61 year and 55.80±11.12 year, respectively. Mean exacerbations in both groups were 2.98±1.25 and 0.55±0.730, respectively. FECOPD group and I-FECOPD group differed significantly with respect to duration of illness (21.73±5.53 year vs. 17.07±5.22 year), FEV1 (1.270±0.247 L vs. 1.711±0.306 L) and PEFR (247.04±49.40 L/min vs. 335.32±61.15 L/min) but not regarding smoking (35.40±10.90 pack years vs. 30.06±10.52 pack years). Mean rare tone P300 latency was significantly increased in FECOPD group compared to I-FECOPD group (330.45±18.64 ms vs. 303.06±15.71 ms); there was no statistically significant difference between two groups regarding mean P300 amplitude (4.82±2.95 µV vs. 4.89±6.47 µV). P300 latency correlated directly with number of exacerbations, age, duration of illness and clinical scores. P300 correlated inversely with spirometric indices and there was no correlation with smoking pack years. Regression model showed frequent acute exacerbations being the strongest predictor of increase in P300 latency.

CONCLUSIONS: Cognitive functions assessed using event related potentials P300 were impaired in frequent acute exacerbations group. P300 latency correlated with exacerbations, age, duration of illness and spirometric indices. Frequent acute exacerbations parameter was the strongest predictor of cognitive impairment.

CLINICAL IMPLICATIONS: Event related potentials, P300 is widely used for assessment of cognitive functions; however, in present study we evaluated its usefulness in COPD patients with frequent acute exacerbations.

DISCLOSURE: The following authors have nothing to disclose: Dipti Agarwal, Sushma Sood, Prem Parkash Gupta

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