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)

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

In: BMC Cardiovascular Disorders, Vol. 20, No. 1, 439, 07.10.2020.

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TY - JOUR

T1 - Neuropsychological outcome after cardiac arrest

T2 - A prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2)

AU - Blennow Nordström, Erik

AU - Lilja, Gisela

AU - Vestberg, Susanna

AU - Ullén, Susann

AU - Friberg, Hans

AU - Nielsen, Niklas

AU - Heimburg, Katarina

AU - Evald, Lars

AU - Mion, Marco

AU - Segerström, Magnus

AU - Grejs, Anders M.

AU - Keeble, Thomas

AU - Kirkegaard, Hans

AU - Ljung, Hanna

AU - Rose, Sofia

AU - Wise, Matthew P.

AU - Rylander, Christian

AU - Undén, Johan

AU - Cronberg, Tobias

PY - 2020/10/7

Y1 - 2020/10/7

N2 - 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

AB - 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

KW - Cardiac arrest

KW - Cognitive dysfunction

KW - Cognitive screening

KW - Neuropsychological tests

KW - Outcome

UR - http://www.scopus.com/inward/record.url?scp=85092467444&partnerID=8YFLogxK

U2 - 10.1186/s12872-020-01721-9

DO - 10.1186/s12872-020-01721-9

M3 - Article

C2 - 33028221

AN - SCOPUS:85092467444

VL - 20

JO - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

SN - 1471-2261

IS - 1

M1 - 439

ER -