Abstract
Background: There is a paucity of research regarding the feasibility and association of cerebral cortex function to patient outcomes after acute respiratory failure (ARF).Purpose: To determine the feasibility of functional connectivity measures and examine the association of functional connectivity to a multifaceted battery of outcomes in survivors of ARF.Methods: Eight ARF patients (age:58±3.7, ICU days:10.4±8.6) completed functional magnetic resonance imaging (fMRI), cognitive, physical-function, anxiety, depression, and driving simulator tests at one month post-hospital discharge. Pearson’s correlations assessed the relationship between functional connectivity within the default mode network (FPN), sensorimotor network (SMN), and frontoparietal network (FPN) to outcomes.Results: Low physical-function (r=0.75, p=0.03) and divided-attention (r=-0.86, p=0.03) during the driving simulator task correlated with low FPN connectivity. Low SMN connectivity demonstrated relationships to slower gait speed (r=0.82, p=0.01) and low short physical performance battery (SPPB) scores (r=0.81, p=0.01).Conclusions: fMRI is feasible to assess ARF patients’ post-ICU limitations, as low post-ARF brain connectivity may be linked to low physical function, providing potential development of therapeutic interventions.
Highlights
Patients surviving critical illnesses such as sepsis and acute respiratory failure (ARF) often suffer impairments in cognitive function, decreased mobility, and increased prevalence of psychiatric disorders such as depression and anxiety [1]
Conclusions: functional magnetic resonance imaging (fMRI) is feasible to assess ARF patients’ post-intensive care unit (ICU) limitations, as low post-ARF brain connectivity may be linked to low physical function, providing potential development of therapeutic interventions
The data may suggest that cortical changes in the default mode network (DMN), frontoparietal network (FPN), and sensorimotor network (SMN) are significantly related to cognitive and emotional health impairments; the small sample and exploratory nature of the study may limit the strength of these arguments
Summary
Patients surviving critical illnesses such as sepsis and acute respiratory failure (ARF) often suffer impairments in cognitive function, decreased mobility, and increased prevalence of psychiatric disorders such as depression and anxiety [1]. The corresponding findings within critical care survivors of neurophysiologic, functional, and structural abnormalities often mirror changes observed in advanced aging and progressive neurodegenerative disorders, such as Alzheimer’s disease [8]. At this juncture, it remains unclear, how the patterns of cortical functional connectivity relate to post-ICU patients’ outcomes. There is a paucity of research regarding the feasibility and association of cerebral cortex function to patient outcomes after acute respiratory failure (ARF).
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