Hemodynamic Responses and Brain Activity During Dual Tasks in COPD Patients Versus Healthy Individuals
NCT ID: NCT06974448
Last Updated: 2025-05-16
Study Results
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Basic Information
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NOT_YET_RECRUITING
32 participants
OBSERVATIONAL
2025-05-15
2026-10-09
Brief Summary
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Cognitive dysfunction is joint in patients with chronic obstructive pulmonary disease (COPD).
In particular, there are effects in tasks that require attention, executive functions, and working memory related to the prefrontal cortex. These effects make it difficult to perform two tasks simultaneously and cause performance errors. The number of studies investigating the effects of cognitive impairments on dual-task performance in COPD is limited. In these studies, no tests were applied specifically for attention and working memory areas; therefore, the brain's neural activity was not investigated during these tests. Multimodal approaches are recommended for a comprehensive assessment of the functional activity of the brain. Multimodal approaches provide more accurate results than single-modality approaches. In the integrated electroencephalography (EEG)-functional near-infrared spectroscopy (fNIRS) approach, EEG provides adequate temporal resolution, while fNIRS offers better spatial resolution and is robust to noise. There is no study in COPD where simultaneous fNIRS-EEG measurements were made during both cognitive tests and dual tasks. In our study, the simultaneous measurement of frontal hemodynamic responses and electrical brain activity in both cognitive tests and dual-task conditions and the examination of the relationship between the results and arterial stiffness, balance, exercise capacity, anxiety, depression, and quality of life scores, which are reported to be related to cognitive function in COPD, constitute the original aspect of our study. The study will include 16 COPD and 16 healthy individuals. The same assessments will be made in both groups, and the results will be compared. General and task-specific cognitive tests, prefrontal cortex oxygenation (fNIRS), electrical brain activity (EEG), exercise capacity, muscle oxygenation, arterial stiffness, balance, respiratory function, dyspnea, depression, anxiety, and quality of life will be evaluated. As a result of this study is expected to determine the effects of cognitive function and dual-task on frontal hemodynamic responses and electrical brain activity in COPD.
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Detailed Description
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The required sample size for the project was calculated as 28 individuals, 14 each for the COPD and control groups (G\*Power Version 3.1.9.4, Franz Faul, Universitat Kiel, Germany), with a statistical significance of 94% test power and 0.05 error level for a difference of 3.33 points and 2.59 standard deviation (effect size 1.455) in the Mini-Mental State Examination score assessing cognitive function between the COPD and control groups. Considering a 10% dropout rate for each group, a total of 32 individuals, 16 in each group, will be included in the study.
Exercise tests will be performed with at least one day of rest breaks.
1. st Session
* Patient file information will be recorded.
* A respiratory function test will be performed.
* MoCA and MMDT tests will be performed to evaluate general cognitive status.
* 6DWT tests will be performed. Muscle oxygenation will be measured during the test.
* An SGRQ questionnaire will be administered to the COPD Group.
* NHP questionnaire will be performed.
2. nd Session
* Arterial stiffness measurement will be performed.
* TUG test will be performed.
* The HAD scale will be applied
* Cardiopulmonary exercise capacity will be evaluated. Muscle oxygenation will be measured during the test.
3. rd Session
* Task-specific cognitive tests, Stroop tests, and N-back tests will be performed. fNIRS and EEG measurements will be performed during the Stroop and N-back tests.
* fNIRS and EEG measurements will be made during single and dual tasks.
Data Collection: The researchers will collect data on frontal hemodynamic responses, electrical brain activity, exercise capacity, arterial stiffness, and balance parameters through tests. Data on dyspnea, depression, anxiety, and quality of life measurements will be collected through scales applied during face-to-face interviews.
Data Analysis: Statistical analysis of the data obtained from all volunteers included in the study will be performed using the IBM SPSS 24.0 (SPSS Inc, Chicago, USA) program. Descriptive statistics will be calculated. The conformity of the variables to normal distribution will be evaluated using visual (histogram and probability graphs) and analytical methods (Kolmogorov-Smirnov/Shapiro-Wilk tests). In comparisons between groups, Student t-test will be used when parametric test assumptions are met, and Mann Whitney U test will be used when parametric test assumptions are not met. Chi-square test will be used for comparisons of categorical variables. Correlation between data that are normally distributed will be analyzed using Pearson correlation, and those that are not normally distributed will be analyzed using Spearman correlation. The error probability will be accepted as p\<0.05.
Conditions
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Study Design
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CASE_CONTROL
CROSS_SECTIONAL
Study Groups
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COPD Group
No interventions assigned to this group
Control Group
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
* Being between the ages of 40-65
* Not having a history of exacerbations in the last 4 week
* Being willing to participate in the study
* Being between the ages of 40-65
* Being willing to participate in the study
Exclusion Criteria
* Presence of ischemic heart disease, uncontrolled hypertension, and diabetes mellitus
* Presence of obstructive sleep apnea syndrome
* Untreated tumors
* Known history of dementia
* Existing musculoskeletal, neuromuscular, or neurological diseases that may prevent participation in the tests
* Not being willing to participate in the study
* Having a known chronic health problem
* Not being willing to participate in the study
40 Years
65 Years
ALL
Yes
Sponsors
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Hacettepe University
OTHER
Responsible Party
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Melike Meşe Buran
MSc, PT
Principal Investigators
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Melike Mese- Buran, Msc, PT.
Role: PRINCIPAL_INVESTIGATOR
Hacettepe University
Locations
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Hacettepe University Faculty of Physical Therapy and Rehabilitation
Ankara, , Turkey (Türkiye)
Countries
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Central Contacts
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References
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Kucukdeveci AA, McKenna SP, Kutlay S, Gursel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000 Mar;23(1):31-8. doi: 10.1097/00004356-200023010-00004.
Polatli M, Yorgancioglu A, Aydemir O, Yilmaz Demirci N, Kirkil G, Atis Nayci S, Kokturk N, Uysal A, Akdemir SE, Ozgur ES, Gunakan G. [Validity and reliability of Turkish version of St. George's respiratory questionnaire]. Tuberk Toraks. 2013;61(2):81-7. doi: 10.5578/tt.5404. Turkish.
Zhang L, Sun J, Sun B, Luo Q, Gong H. Studying hemispheric lateralization during a Stroop task through near-infrared spectroscopy-based connectivity. J Biomed Opt. 2014 May;19(5):57012. doi: 10.1117/1.JBO.19.5.057012.
Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x.
Gungen C, Ertan T, Eker E, Yasar R, Engin F. [Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population]. Turk Psikiyatri Derg. 2002 Winter;13(4):273-81. Turkish.
Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, Wanger J, MacIntyre N, Kaminsky DA, Culver BH, Revill SM, Hernandes NA, Andrianopoulos V, Camillo CA, Mitchell KE, Lee AL, Hill CJ, Singh SJ. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014 Dec;44(6):1428-46. doi: 10.1183/09031936.00150314. Epub 2014 Oct 30.
Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999 Jan;159(1):179-87. doi: 10.1164/ajrccm.159.1.9712108.
Kaygusuz MH, Oral Tapan O, Tapan U, Genc S. Balance impairment and cognitive dysfunction in patients with chronic obstructive pulmonary disease under 65 years. Clin Respir J. 2022 Mar;16(3):200-207. doi: 10.1111/crj.13469. Epub 2022 Jan 26.
Alvarez-Bueno C, Cunha PG, Martinez-Vizcaino V, Pozuelo-Carrascosa DP, Visier-Alfonso ME, Jimenez-Lopez E, Cavero-Redondo I. Arterial Stiffness and Cognition Among Adults: A Systematic Review and Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc. 2020 Mar 3;9(5):e014621. doi: 10.1161/JAHA.119.014621. Epub 2020 Feb 28.
Li R, Yang D, Fang F, Hong KS, Reiss AL, Zhang Y. Concurrent fNIRS and EEG for Brain Function Investigation: A Systematic, Methodology-Focused Review. Sensors (Basel). 2022 Aug 5;22(15):5865. doi: 10.3390/s22155865.
Reijnders T, Troosters T, Janssens W, Gosselink R, Langer D, Davenport PW, von Leupoldt A. Brain Activations to Dyspnea in Patients With COPD. Front Physiol. 2020 Jan 24;11:7. doi: 10.3389/fphys.2020.00007. eCollection 2020.
Hassan SA, Bonetti LV, Kasawara KT, Beal DS, Rozenberg D, Reid WD. Decreased automaticity contributes to dual task decrements in older compared to younger adults. Eur J Appl Physiol. 2022 Apr;122(4):965-974. doi: 10.1007/s00421-022-04891-w. Epub 2022 Jan 27.
Hassan SA, Campos MA, Kasawara KT, Bonetti LV, Patterson KK, Beal DS, Fregonezi GAF, Stanbrook MB, Reid WD. Changes in Oxyhemoglobin Concentration in the Prefrontal Cortex during Cognitive-Motor Dual Tasks in People with Chronic Obstructive Pulmonary Disease. COPD. 2020 Jun;17(3):289-296. doi: 10.1080/15412555.2020.1767561. Epub 2020 May 22.
Gore S, Blackwood J, Ziccardi T. Associations Between Cognitive Function, Balance, and Gait Speed in Community-Dwelling Older Adults with COPD. J Geriatr Phys Ther. 2023 Jan-Mar 01;46(1):46-52. doi: 10.1519/JPT.0000000000000323. Epub 2021 Jul 29.
Wen XH, Li Y, Han D, Sun L, Ren PX, Ren D. The relationship between cognitive function and arterial partial pressure O2 in patients with COPD: A meta-analysis. Medicine (Baltimore). 2018 Jan;97(4):e9599. doi: 10.1097/MD.0000000000009599.
Higbee DH, Dodd JW. Cognitive impairment in COPD: an often overlooked co-morbidity. Expert Rev Respir Med. 2021 Jan;15(1):9-11. doi: 10.1080/17476348.2020.1811090. Epub 2020 Aug 26. No abstract available.
Related Links
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GLOBAL STRATEGY FOR PREVENTION, DIAGNOSIS AND MANAGEMENT OF COPD: 2023 Report
Other Identifiers
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SBA 24/860
Identifier Type: -
Identifier Source: org_study_id
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