Alteration of brain structural organization after sepsis with Fatigue - a structural brain network analysis
Article Sidebar
Main Article Content
Abstract
In our recent cross-sectional investigation, we found in sepsis survivors with persistent cognitive impairment a high number of patients who still suffer from Fatigue. This finding is of importance because Fatigue is highlighted as an associated long-term sequela after sepsis and therefore these patients require an appropriate rehabilitation therapy.
The aim of this study was to verify whether sepsis survivors with both cognitive impairment and Fatigue show any alteration in brain structure.
19 survivors of severe sepsis (longer than 2 years post sepsis) with persistent cognitive deficits ascertained with a battery of neuropsychological tests with cognitive and motor Fatigue symptoms (according to two German Fatigue scales) were investigated with a high-resolution.
T1 weighted image of the brain at a 3.0 Tesla MRI scanner. The Voxel-based morphometry (VBM) was performed using VBM8 toolbox. 19 age- and sex-matched healthy control subjects were also scanned with MRI.
VBM analysis revealed significant gray matter volume reduction in sepsis survivors particularly in the lateral frontal operculum and anterior cingulate cortex. These regions are part of the cingulo-opercular network which maintains alertness. Gray matter volume loss of the orbitofrontal cortex is functionally associated with Fatigue.
These findings emphasize that networks of structural brain organization can be altered with corresponding clinical symptoms and neuropsychological deficits after sepsis.
Downloads
Article Details
Copyright (c) 2021 Seidel G, et al.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.
We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.
Peertechz accomplice with- [CC BY 4.0]
Explanation
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:
|
License Name |
Permission to read and download |
Permission to display in a repository |
Permission to translate |
Commercial uses of manuscript |
|
CC BY 4.0 |
Yes |
Yes |
Yes |
Yes |
The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.
Bolton CF (1993) Neuromuscular complications of sepsis. Intensive Care Med 19: S58- S63. Link: https://bit.ly/3giUo1b
Bolton CF, Young GB, Zochodne DW (1993) The neurological complications of sepsis. Ann Neurol 33: 94-100. Link: https://bit.ly/34XsbHT
Streck EL, Comim CM, Barichello T, Quevedo J (2008) The septic brain. Neurochem Res 33: 2171-2177. Link: https://bit.ly/3vY7SWt
Girard TD, Jackson JC, Pandharipande PP, Pun BT, Thompson JL, et al. (2010) Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Crit Care Med 38: 1513-1520. Link: https://bit.ly/3pqvFvM
Gunther ML, Morandi A, Krauskopf E, Pandharipande P, Girard TD, et al. (2012) The association between brain volumes, delirium duration, and cognitive outcomes in intensive care unit survivors: the VISIONS cohort magnetic resonance imaging study. Crit Care Med 40: 2022-2032. Link:
Hopkins RO, Jackson JC (2006) Long-term neurocognitive function after critical illness. Chest 130: 869-878. Link: https://bit.ly/3cm9T7l
Iwashyna TJ, Ely EW, Smith DM, Langa KM (2010) Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA 304: 1787-1794. Link: https://bit.ly/3x2HR8F
Jackson JC, Ely EW (2013) Cognitive impairment after critical illness: etiologies, risk factors, and future directions. Semin Respir Crit Care Med 34: 216-222. Link: https://bit.ly/34ThDcH
Jackson JC, Mitchell N, Hopkins RO (2011) Cognitive functioning, mental health, and quality of life in ICU survivors: an overview. Crit Care Clin 29: 751-764. Link: https://bit.ly/3x03FBQ
Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, et al. (2013) Long-term cognitive impairment after critical illness. N Engl J Med 369: 1306-1316. Link: Link: https://bit.ly/3w2xcL5
Semmler A, Widmann CN, Okulla T, Urbach H, Kaise M, et al. (2013) Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors. J Neurol Neurosurg Psychiatry 84: 62-69. Link:
Morandi A, Rogers BP, Gunther ML, Merkle K, Pandharipande P, et al. (2012) The relationship between delirium duration, white matter integrity, and cognitive impairment in intensive care unit survivors as determined by diffusion tensor imaging: the VISIONS prospective cohort magnetic resonance imaging study. Crit Care Med 40: 2182-2189. Link: https://bit.ly/3ioksu7
Orhun G, Esen F, Ozcan PE, Sencer S, Bilgic B, et al. (2018) Neuroimaging Findings in Sepsis-Induced Brain Dysfunction: Association with Clinical and Laboratory Findings. Neurocrit Care 30: 106-117. Link: https://bit.ly/3inznVM
Seidel G, Götz T, Hamzei F (2019) Should Fatigue Be Considered as A Long-Term Sequela After Sepsis? Open Access Journal of Neurology and Neurosurgery 10. Link: https://bit.ly/34X3ivM
Ashburner J, Friston KJ (2000) Voxel-based morphometry--the methods. Neuroimage 11: 805-821. Link: https://bit.ly/3pqv5OC
Posner MI (2008) Measuring alertness. Ann N Y Acad Sci 1129: 193-199. Link: https://bit.ly/357VoA5
Flachenecker P, Kumpfel T, Kallmann B, Gottschalk M, et al. (2002) Fatigue in multiple sclerosis: a comparison of different rating scales and correlation to clinical parameters. Mult Scler 8: 523-526. Link: https://bit.ly/2TDrJMm
Flachenecker P, Muller G, Konig H, Meissner H, Toyka KV, et al. (2006) Fatigue” in multiple sclerosis. Development and and validation of the “Wurzburger Fatigue Inventory for MS”. Nervenarzt 77: 165-166. Link: https://bit.ly/3vY7aIN
Penner IK, Raselli C, Stocklin M, Opwis K, Kappos L, et al. (2009) The Fatigue Scale for Motor and Cognitive Functions (FSMC): validation of a new instrument to assess multiple sclerosis-related fatigue. Mult Scler 15: 1509-1517. Link: https://bit.ly/34W5rYB
Bitter T, Bruderle J, Gudziol H, Burmeister HP, Gaser C, et al. (2010) Gray and white matter reduction in hyposmic subjects--A voxel-based morphometry study. Brain Res 1347: 42-47. Link: https://bit.ly/3z7qrcV
Sadaghiani S, Poline JB, Kleinschmidt A, D’Esposito M (2015) Ongoing dynamics in large-scale functional connectivity predict perception. Proc Natl Acad Sci U S A 112: 8463-8468. Link: https://bit.ly/2S6KIPh
Sadaghiani S, Scheeringa R, Lehongre K, Morillon B, Giraud AL, et al. (2010) Intrinsic connectivity networks, alpha oscillations, and tonic alertness: a simultaneous electroencephalography/functional magnetic resonance imaging study. J Neurosci 30 10243-10250. Link: https://bit.ly/3uYuxAH
Tajima S, Yamamoto S, Tanaka M, Kataoka Y, Iwase M, et al. (2010) Medial orbitofrontal cortex is associated with fatigue sensation. Neurol Res Int 671421. Link: https://bit.ly/3za7dmK
Eickhoff SB, Stephan KE, Mohlberg H, Grefkes C, Fink GR, et al. (2005) A new SPM toolbox for combining probabilistic cytoarchitectonic maps and functional imaging data. Neuroimage 25: 1325-1335. Link:
Dosenbach NU, Fair DA, Miezin FM, Cohen AL, Wenger KK, et al. (2007) Distinct brain networks for adaptive and stable task control in humans. Proc Natl Acad Sci U S A 104: 11073-11078. Link: https://bit.ly/3x2GQNT
Posner MI, Petersen SE (1990) The attention system of the human brain. Annu Rev Neurosci 13: 25-42. Link: https://bit.ly/3ilPwuE
Sturm W, de Simone A, Krause BJ, Specht K, Hesselmann V, et al. (1999) Functional anatomy of intrinsic alertness: evidence for a fronto-parietal-thalamicbrainstem network in the right hemisphere. Neuropsychologia 37: 797-805. Link: https://bit.ly/3fX8INP
Sturm W, Willmes K (2001) On the functional neuroanatomy of intrinsic and phasic alertness. Neuroimage 14: S76-S84. Link: https://bit.ly/3z77I15
Morandi A, Pandharipande PP, Jackson JC, Bellelli G, Trabucchi M, et al. (2012) Understanding terminology of delirium and long-term cognitive impairment in critically ill patients. Best Pract Res Clin Anaesthesiol 26: 267-276. Link: https://bit.ly/34RPJ0P
Hakamata Y, Matsuoka Y, Inagaki M, Nagamine M, Hara E, et al. (2007) Structure of orbitofrontal cortex and its longitudinal course in cancer-related post-traumatic stress disorder. Neurosci Res 59: 383-389. Link:
Hanson JL, Chung MK, Avants BB, Shirtcliff EA, Gee JC, et al. (2010) Early stress is associated with alterations in the orbitofrontal cortex: a tensor-based morphometry investigation of brain structure and behavioral risk. J Neurosci 30: 7466-7472. Link: https://bit.ly/3vYzril
Holz NE, Boecker R, Hohm E, Zohsel K, Buchmann AF, et al. (2015) The Long-Term Impact of Early Life Poverty on Orbitofrontal Cortex Volume in Adulthood: Results from a Prospective Study Over 25 Years. Neuropsychopharmacology 40: 996-1004. Link: https://bit.ly/3gcMxly
Mychasiuk R, Muhammad A, Kolb B (2016) Chronic stress induces persistent changes in global DNA methylation and gene expression in the medial prefrontal cortex, orbitofrontal cortex, and hippocampus. Neuroscience 322: 489-499. Link: https://bit.ly/2S6SEjz
Varga Z, Csabai D, Miseta A, Wiborg O, Czéh B (2016) Chronic stress affects the number of GABAergic neurons in the orbitofrontal cortex of rats. Behav Brain Res 316: 104-114. Link: https://bit.ly/3giqtpN
Xu C, Ma XM, Chen HB, Zhou MH, Qiao H, et al. (2016) Orbitofrontal cortex 5-HT2A receptor mediates chronic stress-induced depressive-like behaviors and alterations of spine density and Kalirin 7. Neuropharmacology 109: 7-17. Link: https://bit.ly/3fVnsMX
Dansie EJ, Heppner P, Furberg H, Goldberg J, Buchwald D, et al. (2012) The comorbidity of self-reported chronic fatigue syndrome, post-traumatic stress disorder, and traumatic symptoms. Psychosomatics 53: 250-257. Link: https://bit.ly/3fVoybC
Hirsch JK, Sirois FM (2016) Hope and fatigue in chronic illness: The role of perceived stress. J Health Psychol 21: 451-456. Link: https://bit.ly/3cjrFrG
Lopes-Junior LC, Bomfim EO, Nascimento LC, Nunes MD, Pereira-da-Silva G, et al. (2015) Non-pharmacological interventions to manage fatigue and psychological stress in children and adolescents with cancer: an integrative review. Eur J Cancer Care (Engl) 25: 921-935. Link: https://bit.ly/3v2BikV
Miguel-Hidalgo JJ, Jiang W, Konick L, Overholser JC, Jurjus GJ, et al. (2013) Morphometric analysis of vascular pathology in the orbitofrontal cortex of older subjects with major depression. Int J Geriatr Psychiatry 28: 959-970. Link: https://bit.ly/3fZFCNU
Scheuerecker J, Meisenzahl EM, Koutsouleris N, Roesner M, Schopf V, et al. (2010) Orbitofrontal volume reductions during emotion recognition in patients with major depression. J Psychiatry Neurosci 35: 311-320. Link:
Webb CA, Weber M, Mundy EA, Killgore WD (2014) Reduced gray matter volume in the anterior cingulate, orbitofrontal cortex and thalamus as a function of mild depressive symptoms: a voxel-based morphometric analysis. Psychol Med 44: 2833-2843. Link: https://bit.ly/3fZswjH
Brown LF, Kroenke K (2009) Cancer-related fatigue and its associations with depression and anxiety: a systematic review. Psychosomatics 50: 440-447. Link: https://bit.ly/3z1sJu9
Corfield EC, Martin NG, Nyholt DR (2016) Co-occurrence and symptomatology of fatigue and depression. Compr Psychiatry 71: 1-10. Link:
Simpson S, Tan H, Otahal P, Taylor B, Ponsonby AL, et al. (2016) Anxiety, depression and fatigue at 5-year review following CNS demyelination. Acta Neurol Scand 134: 403-413. Link: https://bit.ly/3z87yXd
Jackson JC, Gordon SM, Ely EW, Burger C, Hopkins RO (2004) Research issues in the evaluation of cognitive impairment in intensive care unit survivors. Intensive Care Med 30: 2009-2016. Link: https://bit.ly/3in3sof
Jackson JC, Gordon SM, Hart RP, Hopkins RO, Ely EW (2004) The association between delirium and cognitive decline: a review of the empirical literature. Neuropsychol Rev 14: 87-98. Link: https://bit.ly/3cmR57W