Objective: To find out phenotypes of movement disorders related to COPD, and also associated factors.

Background: Movement disorders in systemic diseases exactly are common in general wards and In-Patient department of internal medicine. More than being an indicator of central nervous system involvement of medical underlying diseases, abnormal movements also represent severity and complications which can be factors related to prolonged hospitalization and morbidity. There are reviews on textbook (1) that autoimmunity, oncology, systemic infections, HIV/AIDS, metabolic, endocrinology, liver, renal, and hematology diseases show clinical presentation of movement disorders. However, for the respiratory system, there seems to be no research and report about abnormal movements in this condition.

Method: Eighty-six COPD patients were included. The baseline characteristics, education levels, the frequency of hospitalization, COPD assessment test (CAT) score were recorded as variables. All volunteers completed neurological, movement disorders and cognitive examinations. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Roland Universal Dementia Assessment Scale (RUDAS) were applied to estimate dementia. MRI brain or CT scan of the brain were done in volunteers who failed in any test.

Results: There are 16 COPD patients (18.6%) met the criteria of dementia. For the overall prevalence of movement disorders, 34 patients (39.5%) had presented 20.9% postural tremor , 11.6% parkinsonism , and 7% essential tremor. Factors associated with abnormal movements are an amount of cigarette smoking (>46 packs/year), a history of hospital admission due to exacerbation, dementia, and severe COPD (group D) at p<0.05. The multivariate analysis confirms the potency of a history of hospital admission and dementia at p<0.05 OR3.65 95%CI 1.41-9.41, and p<0.05 OR3.85, 95%CI 1.16-12.76, orderly.

Conclusion: Abnormal movements can be found in COPD cases. Although factors associated are not directly the dysfunction of the neuronal circuit, sequalaes of severe hypoxia causes dementia, and other neurodegeneration should be considered.

References: Poewe W, Jankovic J. Movement disorders in neurologic and systemic disease, 1 edition. Cambridge University Press, 2014.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/movement-disorders-in-chronic-obstructive-pulmonary-disease-copd-the-effect-of-pulmonary-disease-to-brain/