Smokers who develop Chronic Obstructive Pulmonary Disease (COPD) may also lose the ability to think clearly as they age. A University of Iowa researcher is leading a diverse team of specialists to initiate one of the most comprehensive investigations into the way that multiple body systems may contribute to this cognitive impairment.
Karin Hoth, PhD, a neuropsychologist in the UI Department of Psychiatry, was recently awarded a $3.1 million grant from the National Institutes of Health to lead a multidisciplinary team that will look at how lung and blood vessel changes, which are often linked to COPD, affect brain structure and function.
The team includes Professors Peg Nopoulos and Stephan Arndt in psychiatry, along with experts from a number of different departments.
“The project is truly a multidisciplinary effort” Hoth said.
Key collaborators also include Professors Gary Pierce in the Department of Health and Human Physiology and director of the Translational Human Vascular Physiology Lab, Alejandro Comellas in the Department of Internal Medicine, Eric Hoffman and John Newell in the Department of Radiology, and Vince Magnotta in the Department of Radiology and director of the MR Research Facility.
“Karin’s project is quite unique in that it brings together researchers from pulmonary and cardiovascular physiology, psychiatry, radiology and more to evaluate the many problems associated with COPD,” said Eric Hoffman, PhD, who runs the Advanced Pulmonary Physiomic Imaging Laboratory at Iowa.
COPD is a condition in which airflow is blocked in the lungs typically as a result of an inflammatory response to cigarette smoke. It is the third leading cause of death in the United States, according to the Centers for Disease Control.
In addition to causing shortness of breath, COPD is linked to cardiovascular disease and an estimated 40-60 percent of people with COPD show cognitive difficulties such as memory loss, problems with decision making, and slowed brain processing.
Hoth’s team will look at how lung and blood vessel dysfunction are related to brain changes in smokers who are in the very early stages of COPD. The project is taking a novel approach by including cardiovascular function in its model.
“Since COPD is so complex, looking at one aspect of what’s going on in the body is missing the boat, it’s not capturing the complexity of the disease,” Hoth said. “The lungs and cardiovascular system are closely linked in their function, and it felt overly simplistic not to include a broader model in our research. We’re bringing together fields that often are separated to see the same patients and then integrating the information that we collect to form a whole picture.”
Hoth says that some chronic smokers who show COPD-related lung problems on a CT scan also have dysfunctional blood vessels, some of which feed the brain. This likely contributes to changes in the brain that are linked to cognitive problems, she says.
Participants will complete extensive cognitive testing and undergo MRI scans of the brain. Hoth hopes to understand which smokers are at risk for developing cognitive difficulties and how that process begins early on.
“We’ll be looking at subtle cognitive changes and difficulties rather than significant impairment,” Hoth said. “Early change is where we can intervene.”
Those early interventions may include adjustments to exercise and diet to specifically increase vascular health.
Hoth began her career at National Jewish Health in Denver, one of the top hospitals in pulmonary medicine. There she recognized the pervasiveness of COPD and the apparent link between changes in blood vessels and brain function.