European Journal of Molecular & Clinical Medicine

Abstract

Background:Chronic obstructive pulmonary disease (COPD) is characterized by
obstruction in airflow; however, COPD is a systemic illness. Neurophysiological
alterations, such as nerve conduction (monosynaptic reflex test) and strength, have been
correlated with smoking, the severity of the disease, hypoxemia, age, hypercapnia and
peak expiratory flow. In this study, we aimed to evaluate the peripheral nervous system
(PNS) with electromyography (EMG) method in patients with COPD and to examine
their relationship with each other.
Materials and Methods: The study was conducted in the Department of Physiology in
collaboration with the Department of Pulmonary Medicine in New Delhi Medical
College and Hospital in Delhi. Our study was conducted among two groups: patient
group (included COPD cases) and control group (included healthy volunteers).
Spirometry was done using MEDGRAPHICS body plethysmograph. Nerve conduction
studies were performed on median, ulnar, peroneal, tibial and sural nerves using
NEURO– MEP–NET EMG/NCV/EP (NEUROSOFT TM) Equipment. The data for
each nerve parameter in the two groups were analyzed Students’ T test.
Results: 39 patients with stable COPD in addition to 39 healthy volunteers as a control
were included in this study. The mean age for patient group was 62.78±7.11 years and
for control group it was 60.13±9.83 years. Males in the patient group were 89.7% and in
control group they were 87.2%. The pulmonary function tests revealed a significant
decrease of FEV1, and FEV1/FVC in the COPD group when compared to the control
group. The patient of COPD was grouped in accordance with these GOLD criteria and
28.2% of patients were having Mild COPD, while 35.9% of patients each were having
moderate and severe COPD. Results of the nerve conduction study showed that there
was a statistically significant decrease in amplitude (mv) and velocity (m/s) and increase
in latency (ms) of peripheral nerve motor and sensory in the COPD group when
compared to the control group.
Conclusion: This study shows that advancement in severity of disease predisposes to
neuropathy. Hence, sensory nerve conduction study can be advised routinely and at
regular intervals to the patients suffering from increasing severity of COPD for early
detection of neuropathy.