Exploratory Analyses of Cerebral Gray Matter Volumes After Out-of-Hospital Cardiac Arrest in Good Outcome Survivors

Frontiers in Psychology

Michel Le May¹  Lloyd Duchesne¹  Bonnie Quinlan¹  Santanu Chakraborty³  Heather E. Tulloch⁴  Aziza Byron-Alhassan⁵  Barbara Collins⁵  Zhuo Fang⁵  Andra M. Smith⁵ 

[1] Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada;Department of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada;Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada;Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada;School of Psychology, University of Ottawa, Ottawa, ON, Canada;

关键词: out-of-hospital cardiac arrest;    gray matter volume;    cognition;    myocardial infarction;    magnetic resonance imaging;   

DOI  :  10.3389/fpsyg.2020.00856

来源: DOAJ

【 摘 要 】

BackgroundSurvival rates of cardiac arrest have increased over recent years, however, survivors may still be left with significant morbidity and functional impairment. A primary concern in cardiac arrest survivors is the effect of prolonged hypoxia/ischemia on the brain. The objectives of the present study were threefold: (1) to explore the effect of cardiac arrest on brain gray matter volumes (GMV) in “good outcome” survivors of out-of-hospital cardiac arrest (OHCA), (2) to examine the relationship between GMV, cognitive functioning and arrest factors, and (3) to explore whether OHCA patients differ from a group of patients with myocardial infarction (MI) uncomplicated by cardiac arrest and a group of healthy controls in terms of GMV.MethodsMedically stable OHCA survivors with preserved neurological function and who were eligible for magnetic resonance imaging scanning (MRI; n = 9), were compared to: (1) patients who had experienced a MI (n = 19) and (2) healthy controls (n = 12). Participants underwent brain MRI on a 3T Siemens Trio MRI scanner and GMV was measured by voxel-based morphometry. A comprehensive neuropsychological assessment was also conducted. Global GMV was compared in the three samples using analyses of variance. The relationships between cognition and GMV were examined within group using correlations.ResultsThe OHCA and MI groups showed a similar pattern of differences compared to the healthy control group. Both groups had decreased GMV in the anterior cingulate cortex, bilateral hippocampus, right dorsolateral prefrontal cortex, right putamen, and bilateral cerebellum. There were no significant differences in global or regional GMV between the OHCA and MI groups. Cognitive functioning was correlated with global GMV in the OHCA group; no such correlation was observed in the MI group.ConclusionRegional atrophy was observed in OHCA and MI survivors, compared to a healthy control group, suggesting a common mechanism, presumably preexisting cardiovascular disease. Although similar regional volume differences were observed between the MI and OHCA groups, the relationship between GMV and cognition was only observed in OHCA survivors. We suggest the acute hypoxia/ischemia ensuing from the arrest may interact with diminished neural reserve in select brain areas to expose occult cognitive dysfunction.

【 授权许可】

Unknown