Eight patients with chronic obstructive bronchopulmonary disease were studied. In seven who had wasting associated with chronic respiratory tract disease, evidence of peripheral neuropathy was found on clinical and electromyographic examinations. Histologic changes were also present in muscle and sural nerve biopsy specimens from these patients. Biochemical analysis of these sural nerve specimens showed them to differ from those in normal control subjects and patients with alcoholic neuropathy. It is suggested that the neuropathy in chronic obstructive bronchopulmonary disease might be due to abnormalities in the metabolism of Schwann cells.
"The researchers identified increased nitrosative/oxidative stress and impaired microvascular blood flow regulation as potential mechanisms underlying the link between OSA and diabetic peripheral neuropathy . Importantly, both chronic   and intermittent hypoxia  are closely linked with peripheral neuropathy. In a case– control study examining peripheral nerve function during ischemia in 17 patients with severe OSA without a recognized cause of neuropathy and 10 control subjects, Mayer and colleagues  demonstrated that patients with severe OSA had peripheral nerve dysfunction whose severity was partly related to the level of nocturnal hypoxemia. "
[Show abstract][Hide abstract] ABSTRACT: An increasing body of evidence suggests that obstructive sleep apnoea (OSA) is independently
associated with an increased risk of cardiovascular disease, glucose intolerance, and
deteriorations in glycaemic control. Despite the knowledge of a multifactorial pathogenesis
of long-term diabetes complications, there is a paucity of information on impact of
comorbidities associated with chronic intermittent hypoxemia on development and progression
of chronic diabetes complications. This review explores the clinical and scientific
overlap of OSA and type 2 diabetes mellitus (T2DM) and its possible impact on the development
and progression of diabetes macrovascular and microvascular complications.
Multiple prospective observational cohort studies have demonstrated that OSA significantly
increases the risk of cardiovascular disease independent of potential confounding
risk factors. The current evidence further suggests that OSA with concurrent T2DM is
associated with an increased risk of oxidative stress-induced damage of vulnerable
endothelial and mesangial cells and peripheral nerves. Further studies are needed to
validate the impact of OSA treatment on diabetes micro- and macrovascular complications.
Since it is presently still unknown whether OSA treatment may provide a diabetes-modifying
intervention that could delay or halt the progression of chronic diabetes complications,
the emphasis is on early diagnosis and satisfactory treatment of both OSA and T2DM.
Diabetes Research and Clinical Practice 05/2014; 104(2). DOI:10.1016/j.diabres.2014.01.007 · 2.54 Impact Factor
"Nervous system is also affected during the disease process. 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). "
[Show abstract][Hide abstract] 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). Short-term 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.
[Show abstract][Hide abstract] ABSTRACT: The purpose was to assess functional (balance L-L and A-P displacement, sit-to-stand test (SST) and Tinetti scale - balance and gait) and neurophysiological aspects (patellar and Achilles reflex and strength) relating these responses to the BODE Index.
The neurophysiological alterations found in patients with chronic obstructive pulmonary disease (COPD) are associated with the severity of the disease. There is also involvement of peripheral muscle which, in combination with neurophysiological impairment, may further compromise the functional activity of these patients.
A cross-sectional study design was used. Twenty-two patients with moderate to very severe COPD (> 60 years) and 16 age-matched healthy volunteers served as the control group (CG). The subjects performed spirometry and several measures of static and dynamic balance, monosynaptic reflexes, peripheral muscle strength, SST and the 6-minute walk test.
The individuals with COPD had a reduced reflex response, 36.77 ± 3.23 (p < 0.05) and 43.54 ± 6.60 (p < 0.05), achieved a lower number repetitions on the SST 19.27 ± 3.88 (p < 0.05), exhibited lesser peripheral muscle strength on the femoral quadriceps muscle, 24.98 ± 6.88 (p < 0.05) and exhibited deficits in functional balance and gait on the Tinetti scale, 26.86 ± 1.69 (p < 0.05), compared with the CG. The BODE Index demonstrated correlations with balance assessment (determined by the Tinetti scale), r = 0.59 (p < 0.05) and the sit-to-stand test, r = 0.78 (p < 0.05).
The individuals with COPD had functional and neurophysiological alterations in comparison with the control group. The BODE Index was correlated with the Tinetti scale and the SST. Both are functional tests, easy to administer, low cost and feasible, especially the SST. These results suggest a worse prognosis; however, more studies are needed to identify the causes of these changes and the repercussions that could result in their activities of daily living.
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