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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)

Blennow Nordström, Erik LU ; Lilja, Gisela LU ; Vestberg, Susanna LU ; Ullén, Susann LU ; Friberg, Hans LU ; Nielsen, Niklas LU ; Heimburg, Katarina LU ; Evald, Lars ; Mion, Marco and Segerström, Magnus , et al. (2020) In BMC Cardiovascular Disorders 20(1).
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,... (More)

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

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac arrest, Cognitive dysfunction, Cognitive screening, Neuropsychological tests, Outcome
in
BMC Cardiovascular Disorders
volume
20
issue
1
article number
439
publisher
BioMed Central (BMC)
external identifiers
  • pmid:33028221
  • scopus:85092467444
ISSN
1471-2261
DOI
10.1186/s12872-020-01721-9
language
English
LU publication?
yes
id
241f0297-6889-4d09-bc6d-05ec8368af9c
date added to LUP
2020-11-04 14:14:37
date last changed
2021-06-08 05:19:54
@article{241f0297-6889-4d09-bc6d-05ec8368af9c,
  abstract     = {<p>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 </p>},
  author       = {Blennow Nordström, Erik and Lilja, Gisela and Vestberg, Susanna and Ullén, Susann and Friberg, Hans and Nielsen, Niklas and Heimburg, Katarina and Evald, Lars and Mion, Marco and Segerström, Magnus and Grejs, Anders M. and Keeble, Thomas and Kirkegaard, Hans and Ljung, Hanna and Rose, Sofia and Wise, Matthew P. and Rylander, Christian and Undén, Johan and Cronberg, Tobias},
  issn         = {1471-2261},
  language     = {eng},
  month        = {10},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Cardiovascular Disorders},
  title        = {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)},
  url          = {http://dx.doi.org/10.1186/s12872-020-01721-9},
  doi          = {10.1186/s12872-020-01721-9},
  volume       = {20},
  year         = {2020},
}