Reduced axial diffusivity and increased mode and T2 signals in cerebral white matter of chronic obstructive pulmonary disease using tract-based spatial statistics

  • Sekwang Lee
  • Sung-Bom Pyun
  • Woo-Suk TaeEmail author
Diagnostic Neuroradiology



Chronic obstructive pulmonary disease (COPD) is considered to be a multi-systemic disease involving pathological changes in the brain. This study investigated how diffusion tensor imaging (DTI) parameters in patients with non-hypoxemic COPD differ from those in controls. Moreover, we tried to examine whether the mode of anisotropy (MO) reflects early changes in white matter (WM) integrity in COPD.


DT images were obtained from 13 male COPD patients and 13 age- and sex-matched healthy controls. Raw DT images were processed using an automated tract-based spatial statistics (TBSS) pipeline. DTI scalars of fractional anisotropy (FA); axial, radial, and mean diffusivities (AD, RD, and MD, respectively); MO; and raw T2 signal (S0) were statistically compared between COPD patients and controls. TBSS methods were used for analysis.


In patients with COPD, decreased AD was observed in the temporal stem (TS), corticospinal tract (CST), thalamus, subiculum, crus cerebri, and midbrain. Increased MO values were found in the corpus callosum, CST, internal capsule, cerebellar peduncle (CP), and medial lemniscus (ML). Additionally, increased S0 was found in the TS, CP, pons, and cerebellar tonsil (threshold-free cluster enhancement to a family-wise error rate of p < 0.05).


The results revealed decreased AD and increased MO scalars in COPD patients compared with the controls, although there were no differences in FA, RD, and MD scalars. Decreased AD and increased MO scalars may reflect early changes in WM integrity in COPD patients.


Chronic obstructive pulmonary disease Diffusion tensor imaging Tract-based spatial statistics Brain stem 



This study was funded by the National Research Foundation of Korea (NRF) funded by the Korea government (MSIP) (No. 2017R1D1A1B03030280) and the National Research Foundation of Korea (NRF) funded by the Korea government (MSIP) (No. 2017M3C7A1079696).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Biomedical SciencesKorea University College of MedicineSeoulSouth Korea
  2. 2.Department of Physical Medicine and RehabilitationKorea University College of MedicineSeoulSouth Korea
  3. 3.Brain Convergence Research CenterKorea University College of MedicineSeoulSouth Korea

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