Neuropsychological outcome after cardiac arrest: a prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2)

Erik Blennow Nordström; Gisela Lilja; Susanna Vestberg; Susann Ullén; Hans Friberg; Niklas Nielsen; Katarina Heimburg; Lars Evald; Marco Mion; Magnus Segerström; Anders M. Grejs; Thomas Keeble; Hans Kirkegaard; Hanna Ljung; Sofia Rose; Matthew P. Wise; Christian Rylander; Johan Undén; Tobias Cronberg

doi:10.1186/s12872-020-01721-9

BMC Cardiovascular Disorders (Oct 2020)

Neuropsychological outcome after cardiac arrest: a prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2)

Erik Blennow Nordström,
Gisela Lilja,
Susanna Vestberg,
Susann Ullén,
Hans Friberg,
Niklas Nielsen,
Katarina Heimburg,
Lars Evald,
Marco Mion,
Magnus Segerström,
Anders M. Grejs,
Thomas Keeble,
Hans Kirkegaard,
Hanna Ljung,
Sofia Rose,
Matthew P. Wise,
Christian Rylander,
Johan Undén,
Tobias Cronberg

Affiliations

Erik Blennow Nordström: Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology
Gisela Lilja: Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology
Susanna Vestberg: Lund University, Department of Psychology
Susann Ullén: Skane University Hospital, Clinical Studies Sweden – Forum South
Hans Friberg: Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Intensive and Perioperative Care
Niklas Nielsen: Lund University, Helsingborg Hospital, Department of Clinical Sciences Lund, Anesthesiology and Intensive Care
Katarina Heimburg: Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology
Lars Evald: Hammel Neurorehabilitation and Research Centre
Marco Mion: Essex Cardiothoracic Centre, Basildon and Thurrock University Hospitals
Magnus Segerström: Sahlgrenska University Hospital, Department of Neurology and Department of Cardiology
Anders M. Grejs: Aarhus University Hospital and Aarhus University, Research Centre for Emergency Medicine, Emergency Department and Department of Clinical Medicine
Thomas Keeble: Essex Cardiothoracic Centre, Basildon and Thurrock University Hospitals
Hans Kirkegaard: Aarhus University Hospital and Aarhus University, Research Centre for Emergency Medicine, Emergency Department and Department of Clinical Medicine
Hanna Ljung: Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology
Sofia Rose: Clinical Psychology, Cardiff and Vale University Health Board, NHS Wales
Matthew P. Wise: Cardiff University School of Medicine
Christian Rylander: Sahlgrenska Academy, University of Gothenburg, Institute of Clinical Sciences, Department of Anaesthesiology and Intensive Care Medicine
Johan Undén: Lund University, Skane University Hospital, Department of Clinical Sciences Malmö, Anaesthesiology and Intensive Care Medicine
Tobias Cronberg: Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology

DOI: https://doi.org/10.1186/s12872-020-01721-9
Journal volume & issue: Vol. 20, no. 1
pp. 1 – 11

Abstract

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Abstract Background This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA. Methods This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses. Discussion In this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA. Trial registration ClinicalTrials.gov, NCT03543371 . Registered 1 June 2018

Published in BMC Cardiovascular Disorders

ISSN: 1471-2261 (Online)
Publisher: BMC
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://bmccardiovascdisord.biomedcentral.com

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