Polyneuropathy associated with chronic hypoxaemia: prevalence in patients with chronic obstructive pulmonary disease

Pfeiffer, G.; Kunze, K.; Bruch, Manuel; Kutzner, M; Ladurner, G.; Malin, J.‐P.; Tackmann, W.

doi:10.1007/bf00314624

Cited by 36 publications

(37 citation statements)

References 11 publications

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“…In turn, this could potentially amplify the smoke-dependent abnormalities in cerebrovascular dynamics. While a definite neuropathy has been described in severe COPD [37], the present findings of an immediate modification with breathing manoeuvres suggest that these abnormalities resulted from a still functional (and reversible) disturbance in patients with limited clinical involvement. The clinical implications of an alteration in the autonomic nervous system and cerebrovascular dynamics are clear when considering the recently reported high sensitivity of the solitary tract nucleus to changes in blood flow [38].…”

Section: Autonomic Disturbances In Copd Patientsmentioning

confidence: 39%

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Bernardi¹,

Casucci²,

Haider³

et al. 2008

European Respiratory Journal

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Patients with chronic obstructive pulmonary disease (COPD) may develop hypercapnia and hypoxia, two main determinants of cerebral blood flow. The current authors tested whether cerebrovascular regulation was altered in mild COPD, modified by manoeuvres acutely improving autonomic cardiovascular modulation or influenced by smoking habit.In 15 eucapnic normoxic mild COPD patients (eight smokers) and 28 age-matched controls (14 smokers), midcerebral artery blood flow velocity (MCFV), end-tidal carbon dioxide tension (PET,CO 2 ), arterial oxygen saturation (Sa,O 2 ), ECG and blood pressure at rest were monitored during progressive hypercapnic hyperoxia, isocapnic hypoxia, slow breathing and oxygen administration. MCFV, arterial baroreflex and dynamic MCFV-blood pressure relationships were compared by phase analysis.COPD and control smokers showed higher MCFV (when corrected for PET,CO 2 ), lower cerebrovascular resistance index and lower sensitivity to hypercapnia than nonsmokers, with equal sensitivity to Sa,O 2 and similar phase analysis. Arterial baroreflex was depressed in all COPD patients. Slow breathing and oxygen administration improved baroreflex sensitivity and reduced MCFV in all COPD patients.Patients with mild chronic obstructive pulmonary disease show autonomic dysfunction. Chronic smoking induces cerebral vasodilation and impairs cerebrovascular control. All abnormalities can be partly corrected by improving the cardio-and cerebrovascular autonomic modulation, suggesting that functional autonomic abnormalities are already present at an early stage of disease.

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Section: Autonomic Disturbances In Copd Patientsmentioning

confidence: 39%

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Bernardi¹,

Casucci²,

Haider³

et al. 2008

European Respiratory Journal

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“…Appenzeller et al (1968) firstly reported Wallerian degeneration and demyelinization of the peripheral nerves in patients with COPD (Pfeiffer et al 1990). Afterwards, the role of polyneuropathy (PNP) in COPD has been shown in various studies (Ozge & Atis¸2001;Agrawal et al 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Afterwards, the role of polyneuropathy (PNP) in COPD has been shown in various studies (Ozge & Atis¸2001;Agrawal et al 2007). Hypoxaemia has been proposed as the major factor for the development of polyneuropathy (Pfeiffer et al 1990;Ozge & Atis2 001;Ozge et al 2005). Hypoxaemia may cause neuropathy by its direct effect on the nerve fibres or by increasing the impact of neurotoxic factors.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of visual field parameters in patients with chronic obstructive pulmonary disease

Demir

Inonu

Kurt

et al. 2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the effects of chronic obstructive pulmonary disease (COPD) on retina and optic nerve. Methods: Thirty-eight patients with COPD and 29 healthy controls, totally 67 subjects, were included in the study. Visual evoked potentials (VEP) and visual field assessment (both standard achromatic perimetry (SAP) and short-wavelength automated perimetry (SWAP)) were performed on each subject after ophthalmological, neurological and pulmonary examinations. Results: Mean deviation (MD), pattern standard deviation (PSD) and corrected pattern standard deviation (CPSD) were significantly different between patient and control groups as for both SAP and SWAP measurements (p = 0.001, 0.019, 0.009 and p = 0.004,0.019, 0.031, respectively). Shortterm fluctuation (SF) was not statistically different between the study and the control groups (p = 0.874 and 0.694, respectively). VEP P100 latencies were significantly different between patients with COPD and the controls (p = 0.019). Conclusion: Chronic obstructive pulmonary disease is a systemic disease, and hypoxia in COPD seems to affect the retina and the optic nerve.

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“…Hypoxic neuropathy expressed by peripheral paraesthesia, reduced peripheral sensory nerve conduction and axonal neuropathy is well known in patients with COPD [19, 20, 21, 22]. Symptoms such as postural fainting, diarrhoea, loss of urinary control, erectile impotence and reduced sweating, common in COPD, may be due to autonomic neuropathy [23, 24, 25, 26].…”

Section: Introductionmentioning

confidence: 99%

Effect of Long-Term Oxygen Therapy on Cognitive and Neurological Dysfunction in Chronic Obstructive Pulmonary Disease

Hjalmarsen¹,

Waterloo

Dahl

et al. 1999

Eur Neurol

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The aim of this study was to assess effect of long-term oxygen therapy (LTOT) on the function of central and autonomic nervous system in patients with hypoxaemic chronic obstructive pulmonary disease (COPD). A battery of neuropsychological tests was used together with the Short Test of Mental Status in addition to transcranial Doppler ultrasonography, and five cardiovascular tests as well as a questionnaire on autonomic function. Ten COPD patients, 4 males and 6 females, with a mean age of 65.9 ± 7.3 (SD) years, were studied at the beginning and after 3 months of LTOT. At start PaO₂ was 6.7 ± 1.1 kPa without oxygen and 9.9 ± 1.5 kPa after 3 months with oxygen. Our results demonstrate that neuropsychological function, cerebral blood flow velocity and autonomic function were positively influenced after 3 months of LTOT although the changes did not reach statistical significance. The COPD patients were cognitively impaired as compared to age-matched healthy controls. Our findings were consistent with the previous notion of improvement of hypoxic cognitive dysfunction by LTOT.

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Polyneuropathy associated with chronic hypoxaemia: prevalence in patients with chronic obstructive pulmonary disease

Cited by 36 publications

References 11 publications

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Autonomic and cerebrovascular abnormalities in mild COPD are worsened by chronic smoking

Evaluation of visual field parameters in patients with chronic obstructive pulmonary disease

Effect of Long-Term Oxygen Therapy on Cognitive and Neurological Dysfunction in Chronic Obstructive Pulmonary Disease

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