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Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Memory impairment in out-of-hospital cardiac arrest survivors is associated with global reduction in brain volume, not focal hippocampal injury
Authors: Grubb, Neil R
Fox, Keith A A
Smith, Karen
Best, Jonathan J K
Blane, Annette
Ebmeier, Klaus P
Glabus, Michael F
O'Carroll, Ronan
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Keywords: atrophy
heart arrest
magnetic resonance imaging
Issue Date: Jul-2000
Publisher: American Heart Association
Citation: Grubb NR, Fox KAA, Smith K, Best JJK, Blane A, Ebmeier KP, Glabus MF & O'Carroll R (2000) Memory impairment in out-of-hospital cardiac arrest survivors is associated with global reduction in brain volume, not focal hippocampal injury, Stroke, 31 (7), pp. 1509-1514.
Abstract: Background and Purpose -- More than 30% of out-of-hospital cardiac arrest (OHCA) survivors suffer significant memory impairment. The hippocampus may be vulnerable to hypoxic injury during cardiac arrest. The purpose of this study was to determine whether selective hippocampal injury is the substrate for this memory impairment. Methods -- Seventeen OHCA survivors and 12 patients with uncomplicated myocardial infarction were studied. OHCA survivors were divided into those with impaired and intact memory. Memory was assessed by use of the Rivermead Behavioural Memory Test and Doors and People Test. MRI was used to determine intracranial, whole-brain, amygdala-hippocampal complex, and temporal lobe volumes. Brain structure was also examined by statistical parametric mapping. Results -- Left amygdala-hippocampal volume was reduced in memory-impaired OHCA victims compared with control subjects (mean 3.93 cm3 and 95% CI 3.50 to 4.36 cm3 versus mean 4.65 cm3 and 95% CI 4.37 to 4.93 cm3; P=0.002). Left temporal lobe and whole-brain volumes were also reduced. There were no differences in amygdala-hippocampal volume indexed against ipsilateral temporal lobe volume. Significant correlations were observed between total brain volume and Rivermead Behavioural Memory Test (r=0.56, P less than 0.05) and Doors and People Test (r=0.67, P less than 0.01) scores in OHCA survivors. Both recall and recognition were compromised in memory-impaired subjects. Statistical parametric mapping did not detect focal brain abnormalities in these subjects. Global cerebral atrophy was confirmed by qualitative assessment. Conclusions -- Memory impairment in OHCA survivors is associated with global cerebral atrophy, not selective hippocampal damage. Rehabilitation protocols need to account for the global nature of the brain injury.
Type: Journal Article
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Affiliation: Royal Infirmary of Edinburgh
University of Edinburgh
University of Stirling
University of Edinburgh
University of Edinburgh
University of Edinburgh
University of Edinburgh

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