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

Study Overview
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Brief Summary
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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).

Detailed Description
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The overall aim is to understand the pathophysiological mechanism in delirium and septic encephalopathy and its consequences. For this purpose we will: Provide extensive cognitive testing. These results provide the basis for categorization of patients surviving septic encephalopathy and delirious patients. 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. 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. Third, the investigators will assess plasma markers of free radical production.

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

Conditions
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Septic Encephalopathy, Delirium, Sepsis

Intervention / Treatment
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* Other: Delirium and with septic encephalopathy.


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Delirium and with septic encephalopathy.|Delirium or septic encephalopathy survivors will be analized in the same way: Cognitive tests, EEG and MRI.|

What is the study measuring?
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Primary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sepsis, Encephalopathy, Delirium, ICU, EEG, MRI, Cognitive tests