Cognitive Processing in Patients Surviving Delirium. Neuropsychological, EEG and Structural Brain Correlates.

Overview

The research program explores how delirium influenced brain function in patients surviving delirium and septic encephalopathy from a non neurological specialized ICU cohort from 2013 to 2015 in Rigshospitalet (Glostrup).

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Retrospective
  • Study Primary Completion Date: August 2020

Detailed Description

The overall aim is to understand the pathophysiological mechanism in delirium and septic encephalopathy and its consequences. For this purpose we will: 1. Provide extensive cognitive testing. These results provide the basis for categorization of patients surviving septic encephalopathy and delirious patients. 2. First, the investigators will examine if the differences in cognitive function is reflected in the ability of the brain to generate high-frequency electrical oscillations that accompany and underlie perception, attention, cognition, memory formation and retrieval. It will be performed by carrying out continuous EEG (cEEG) and by examination of steady-state evoked cognitive EEG responses. 3. Second, the investigations will examine MRI, structural and diffusion tensor imaging sequences. Hippocampal, thalamic, amygdala, lentiform nucleus and cingulate cortex volumes will be determined bilaterally and will be compared between individuals with healthy brain aging and patients that survived delirium. 4. Third, the investigators will assess plasma markers of free radical production.

Interventions

  • Other: Delirium and with septic encephalopathy.
    • Delirium or septic encephalopathy survivors will be analized in the same way: Cognitive tests, EEG and MRI.

Clinical Trial Outcome Measures

Primary Measures

  • EEG frequencies
    • Time Frame: Through study completion, an average of 1 year
    • Automatically measurments of frequencies band
  • MRI
    • Time Frame: Through study completion, an average of 1 year
    • Structural and diffusion tensor imaging sequences
  • Cognitive test: Verbal-Paired Associates
    • Time Frame: Through study completion, an average of 1 year
    • Assessing explicit episodic memory performance
  • Cognitive test: Mini-Mental State Examination (MMSE)
    • Time Frame: Through study completion, an average of 1 year
    • neurocognitive function
  • Cognitive test: Trail-Making Test and the Symbol-Digit Modalities Test (SDMT),
    • Time Frame: Through study completion, an average of 1 year
    • Speed of processing and executive functioning

Participating in This Clinical Trial

Inclusion Criteria for the ICU cohort:

  • Age >18 years; – Length of stay >24 hours in the ICU. Exclusion Criteria for the ICU cohort: – Expected death <24 hours; – Psychiatric illness; pre-existing delirium; severe dementia; cerebrovascular event <six months; major surgery <two months; – Non-Danish or English speaking.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Rigshospitalet, Denmark
  • Collaborator
    • University of Copenhagen
  • Provider of Information About this Clinical Study
    • Principal Investigator: Olalla Urdanibia Centelles, MD; PhD Candidate – Rigshospitalet, Denmark

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