Abstract
Objective
To examine the effects of brief hypoxia (<7 min) due to cardiac arrest on the integrity
of the brain and performance on memory and executive functions tasks.
Methods
Patients after out-of-hospital cardiac arrest (CA) (n = 9), who were deemed neurologically
intact on discharge, were compared to matched patients with myocardial infarction
(MI) (n = 9). A battery of clinical and experimental memory and executive functions
neuropsychological tests were administered and MRI scans for all patients were collected.
Measures of subcortical and cortical volumes and cortical thickness were obtained
using FreeSurfer. Manual segmentations of the hippocampus were also performed. APACHE-II
scores were calculated based on metrics collected at admission to ICCU for all patients.
Results
Significant differences between the two groups were observed on several verbal memory
tests. Both hippocampi were significantly reduced (p < 0.05) in the CA patients, relative
to MI patients. Hippocampal subfields segmentation showed significantly reduced presubiculum
volumes bilaterally. CA patients had on average 10% reduction in volumes bilaterally
across hippocampal subfields. No cortical thickness differences survived correction.
Significant correlations were observed in the CA group only between the hippocampal
volumes and performance on verbal memory tasks, including recollection. Hippocampal
volumes and several memory measures (but not other cognitive domains) were strongly
correlated with APACHE-II scores on admission in the CA group, but not in the MI group
Conclusions
Chronic patients with cardiac arrest who were discharged from hospital in “good neurological
condition” showed an average of 10% reduction in hippocampal volume bilaterally and
significant verbal memory deficits relative to matched controls with myocardial infarction,
suggesting even brief hypoxic periods suffice to lead to specific hippocampal damage.
Keywords
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Article info
Publication history
Published online: February 20, 2018
Accepted:
February 15,
2018
Received in revised form:
February 1,
2018
Received:
November 1,
2017
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at https://doi.org/10.1016/j.resuscitation.2018.02.016.
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
