Functional Implication of Corpus Callosum in Voluntary Strength in COPD Patients

5 Santé

Status: Completed

Conditions: Neurophysiology; Physiology

Treatments: Other: Transcranial magnetic stimulation (TMS)

Study type: Interventional

Funder types: Other

Identifiers

NCT03807258

5S_PHYCOM

Details and patient eligibility

About

Patients with COPD have lower capability of activating their muscles. At the cortical level, force production is not only controlled by contralateral primary motor cortex but also by ipsilateral motor cortex. The aim of this study is to determine whether ipsilateral areas are functionally impaired in COPD.

Full description

Chronic obstructive pulmonary disease (COPD) patients exhibit not only respiratory symptoms but also a peripheral muscular weakness. This weakness is characterized by a loss in strength, harmful for the patients' life quality and vital prognosis (Swallow et al., 2007). Even if many studies have enlightened damages at a peripheral level, the muscular atrophy itself cannot totally explain the loss in force (Menon et al., 2012). Furthermore, the contractile properties of COPD muscles fibres are preserved (Debigare et al., 2003). Consequently, peripheral muscle weakness cannot only be explained by peripheral factors and central structures must be investigated.

At the central level, it is admitted that force production is controlled by the activation of contralateral motor areas. In COPD, these areas were found to be less activated than in controls during force production (Alexandre et al., 2014). However, recent studies bring the evidence that ipsilateral motor areas are also mobilized to cope demand during such task. The activation of ipsilateral areas is possible through inter hemispheric pathways, as the corpus callosum. Recently, the integrity of the corpus callosum have been linked to the capability of activating the ipsilateral motor cortex (Chiou et al., 2014) during force production. This is of concern knowing that several studies reported white matter lesions in the brain of COPD patients (Dodd et al, 2012) and more precisely in regions containing the corpus callosum (Lahousse et al., 2013).

Therefore, we hypothesize that COPD patients have a lower capability of activating their ipsilateral motor cortex during force production compared to controls.

Enrollment: 22 patients

Sex: All

Ages: 40 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Health insurance
• Patients : COPD Gold II-IV

Exclusion criteria

• Pregnant women
• Seizures
• Unable to give written consent
• Metalic object above shoulders
• Dermatological issue concerning surface electrodes
• Caffeine consumption > 4 coffee / day
• Neurological disorders
• Opioid-based treatment
• Patients : recent exacerbation (< 4 weeks)
• Patients : rehabilitation in previous 1 year

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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22 participants in 2 patient groups

COPD patients group

Experimental group

Description:

COPD patients undergoing transcranial magnetic stimulation (TMS) evaluations.

Treatment:

Other: Transcranial magnetic stimulation (TMS)

Controls group

Active Comparator group

Description:

Healthy matched controls undergoing transcranial magnetic stimulation (TMS) evaluations.

Treatment:

Other: Transcranial magnetic stimulation (TMS)