Brain connectivity and cognitive functioning in individuals six months after multiorgan failure

• Published in: NeuroImage clinical 2020-01, Vol.25, p.102137-102137, Article 102137
• Main Authors: Jimenez-Marin, Antonio, Rivera, Diego, Boado, Victoria, Diez, Ibai, Labayen, Fermin, Garrido, Irati, Ramos-Usuga, Daniela, Benito-Sánchez, Itziar, Rasero, Javier, Cabrera-Zubizarreta, Alberto, Gabilondo, Iñigo, Stramaglia, Sebastiano, Arango-Lasprilla, Juan Carlos, Cortes, Jesus M.
• Format: Article
• Language: English
• Subjects: Adult; Brain - pathology; Brain - physiopathology; Cognitive Dysfunction - etiology; Cognitive Dysfunction - pathology; Cognitive Dysfunction - physiopathology; Cross-Sectional Studies; Default Mode Network; Default Mode Network - pathology; Default Mode Network - physiopathology; Female; Functional connectivity; Humans; Hyper-connectivity; Image Interpretation, Computer-Assisted - methods; Magnetic Resonance Imaging - methods; Male; Middle Aged; Multiorgan failure; Multiple organ dysfunction syndrome; Multiple Organ Failure - complications; Neuropsychological Evaluation; Regular; Resting state
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2019.102137

•Multiorgan failure (MOF) might produce long-term neurological and cognitive sequelae.•Functional MRI revealed abnormal default mode network  (DMN) connectivity in MOF.•DMN connectivity 6 months after MOF was associated with clinical severity during ICU   .•DMN connectivity was associated with attention and visual-constructional abilities.•Resting-state fMRI is a potential tool for predicting long-term deficits in MOF. Multiorgan failure (MOF) is a life-threating condition that affects two or more systems of organs not involved in the disorder that motivates admission to an Intensive Care Unit (ICU). Patients who survive MOF frequently present long-term functional, neurological, cognitive, and psychiatric sequelae. However, the changes to the brain that explain such symptoms remain unclear. To determine brain connectivity and cognitive functioning differences between a group of MOF patients six months after ICU discharge and healthy controls (HC). 22 MOF patients and 22 HC matched by age, sex, and years of education were recruited. Both groups were administered a 3T magnetic resonance imaging (MRI), including structural T1 and functional BOLD, as well as a comprehensive neuropsychological evaluation that included tests of learning and memory, speed of information processing and attention, executive function, visual constructional abilities, and language. Voxel-based morphometry was used to analyses T1 images. For the functional data at rest, functional connectivity (FC) analyses were performed. There were no significant differences in structural imaging and neuropsychological performance between groups, even though patients with MOF performed worse in all the cognitive tests. Functional neuroimaging in the default mode network (DMN) showed hyper-connectivity towards sensory-motor, cerebellum, and visual networks. DMN connectivity had a significant association with the severity of MOF during ICU stay and with the neuropsychological scores in tests of attention and visual constructional abilities. In MOF patients without structural brain injury, DMN connectivity six months after ICU discharge is associated with MOF severity and neuropsychological impairment, which supports the use of resting-state functional MRI as a potential tool to predict the onset of long-term cognitive deficits in these patients. Similar to what occurs at the onset of other pathologies, the observed hyper-connectivity might suggest network re-adaptation following MOF.