Clinical trial NCT03807258: Functional Implication of Corpus Callosum in Voluntary Strength in COPD Patients
Official title: Functional Implication of Corpus Callosum in Voluntary Strength in COPD Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Neurophysiology
Physiology
Keywords: COPD
Transcranial magnetic stimulation
Motor-evoked potentials
Muscle weakness
Interhemispheric
Inhibition
Lead sponsor: 5 Santé
Sponsor class: OTHER
First posted: 2019-01-16
Enrollment: 22
Sex: ALL
Minimum age (years): 40
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: COPD Patients vs. Controls
Primary purpose: BASIC_SCIENCE

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.

Eligibility criteria: 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

Primary outcomes:
measure: Ipsilateral excitability ratio : rest - 50% mvic
timeFrame: Baseline
Secondary outcomes:
measure: Ipsilateral inhibition ratio : rest - 50% mvic
timeFrame: Baseline
measure: Interhemispheric inhibition
timeFrame: Baseline
measure: Relationship between inter hemispheric inhibition and voluntary strength
timeFrame: Baseline
measure: S100B and GFAP
timeFrame: Baseline
Other outcomes:
Locations:
city: Lodeve
country: France
facility: Cliniques du Souffle
state: Herault
city: Osséja
country: France
facility: Cliniques du Souffle
state: Pyrenees Orientales
Study officials:
affiliation: 5 Santé
name: Nicolas Oliver, MD
role: PRINCIPAL_INVESTIGATOR
References: