title: Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors.
abstract: OBJECTIVE
  The objective of this preliminary study was to explore long-term changes in neurobehavioral parameters, brain morphology and electroencephalography of sepsis patients who received intensive care compared to non-septic intensive care unit (ICU) patients.
  
  
  METHODS
  Two-centre follow-up study 6-24 months after discharge from hospital using published norms and existing databases of healthy controls for comparison. Patients included 25 septic and 19 non-septic ICU survivors who were recruited from two ICUs of a university and community hospital. Measurements used include brain morphology, standard electroencephalography, cognition and psychiatric health and health-related quality of life.
  
  
  RESULTS
  Sepsis survivors showed cognitive deficits in verbal learning and memory and had a significant reduction of left hippocampal volume compared to healthy controls. Moreover, sepsis and to some extent non-septic ICU patients had more low-frequency activity in the EEG indicating unspecific brain dysfunction. No differences were found in health-related quality of life, psychological functioning or depressive symptoms, and depression could be ruled out as a confounding factor.
  
  
  CONCLUSIONS
  This study demonstrates permanent cognitive impairment in several domains in both septic and non-septic ICU survivors and unspecific brain dysfunction. In the sepsis group, left-sided hippocampal atrophy was found compared to healthy controls. Further study is needed to clarify what contribution sepsis and other factors at the ICU make to these outcomes. Specific neuroprotective therapies are warranted to prevent persisting brain changes in ICU patients.
authors.affiliation: Department of Neurology, University of Bonn, Bonn, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Semmler
authors.forename: Catherine Nichols
authors.initials: CN
authors.lastname: Widmann
authors.forename: Thorsten
authors.initials: T
authors.lastname: Okulla
authors.forename: Horst
authors.initials: H
authors.lastname: Urbach
authors.forename: Markus
authors.initials: M
authors.lastname: Kaiser
authors.forename: Guido
authors.initials: G
authors.lastname: Widman
authors.forename: Florian
authors.initials: F
authors.lastname: Mormann
authors.forename: Julia
authors.initials: J
authors.lastname: Weide
authors.forename: Klaus
authors.initials: K
authors.lastname: Fliessbach
authors.forename: Andreas
authors.initials: A
authors.lastname: Hoeft
authors.forename: Frank
authors.initials: F
authors.lastname: Jessen
authors.forename: Christian
authors.initials: C
authors.lastname: Putensen
authors.forename: Michael T
authors.initials: MT
authors.lastname: Heneka
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D001284:Atrophy / Q000473:pathology; D058256:Brain Waves / Q000502:physiology*; D003072:Cognition Disorders / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D003422:Critical Care / Q000523:psychology / Q000706:statistics & numerical data; D003863:Depression / Q000150:complications / Q000523:psychology; D004569:Electroencephalography / Q000379:methods / Q000523:psychology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D018805:Sepsis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology* / Q000523:psychology*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data