Journal Article

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)

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

2020

Overview

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

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Anestesi och intensivvård / Anesthesiology and Intensive Care / Angiology / Blood Transfusion Medicine / Cardiac arrest / Cardiac Surgery / Cardiology / Cardiology and Cardiovascular Disease / Care and treatment / Clinical Trials as Topic / Cognition / Cognition & reasoning / Cognitive ability / Cognitive disorders / Cognitive dysfunction / Cognitive Dysfunction - diagnosis / Cognitive Dysfunction - psychology / Cognitive screening / Complications and side effects / Development and progression / Diagnosis / Episodic memory / Europe / Executive Function / Female / Heart / Heart attacks / Heart Failure & Congenital / Humans / Hypothermia / Hypothermia, Induced - adverse effects / Induced hypothermia / Insomnia / Internal Medicine / Ischemia / Kardiologi och kardiovaskulära sjukdomar / Language / Longitudinal Studies / Male / Medicine / Medicine & Public Health / Memory / Methods / Myocardial infarction / Neurologi / Neurologic manifestations / Neurology / Neuropsychological Tests / Out-of-Hospital Cardiac Arrest - diagnosis / Out-of-Hospital Cardiac Arrest - physiopathology / Out-of-Hospital Cardiac Arrest - psychology / Out-of-Hospital Cardiac Arrest - therapy / Outcome / Patient outcomes / Patients / Prospective Studies / Psychologists / Questionnaires / Research Design / Risk factors / Short term memory / Sleep disorders / Structural Diseases / Study Protocol / Time Factors / Traumatic brain injury / Treatment Outcome