Functional Implication of Corpus Callosum in Voluntary Strength in COPD Patients

Not Applicable

Completed

• Conditions: Physiology; Neurophysiology
• Interventions: Other: Transcranial magnetic stimulation (TMS)

• Registration Number: NCT03807258
• Lead Sponsor: 5 Santé

Brief Summary

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.

Detailed 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.

Study Timeline

• Study Start: 2018-10-20
• Study First Submitted: 2019-01-15
• Study First Submitted QC: 2019-01-15
• Study First Posted: 2019-01-16
• Primary Completion: 2019-03-30
• Study Completion: 2019-03-30
• Status Verified: 2020-01
• Last Update Submitted: 2020-01-10
• Last Update Posted: 2020-01-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 22

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Controls group	Transcranial magnetic stimulation (TMS)	Healthy matched controls undergoing transcranial magnetic stimulation (TMS) evaluations.
COPD patients group	Transcranial magnetic stimulation (TMS)	COPD patients undergoing transcranial magnetic stimulation (TMS) evaluations.

Primary Outcome Measures

Name	Time	Method
Ipsilateral excitability ratio : rest - 50% mvic	Baseline	Ratio of ipsilateral excitability. Measured at rest, and during a 50% max. isometric contraction. Then, ipsilateral excitability ratio = rest / 50% \* 100.

Secondary Outcome Measures

Name	Time	Method
Relationship between inter hemispheric inhibition and voluntary strength	Baseline	Correlation coefficient between inter hemispheric inhibition and maximal isometric force production
S100B and GFAP	Baseline	Serum concentrations of S100B and GFAP proteins, brain lesions markers
Interhemispheric inhibition	Baseline	Interhemispheric inhibition, from contralateral to ipsilateral motor cortex, using reference method from Ferbert et al., 1992.
Ipsilateral inhibition ratio : rest - 50% mvic	Baseline	Ratio of ipsilateral inhibition. Measured at rest, and during a 50% max. isometric contraction. Then, ipsilateral inhibition ratio = rest / 50% \* 100. SICI (2ms) method is used to quantify inhibition.

Trial Locations

Locations (1)

Cliniques du Souffle; 🇫🇷 Osséja, Pyrenees Orientales, France