title: Brain injury after moderate drowning: subtle alterations detected by functional magnetic resonance imaging.
abstract: To describe cerebral (structural and functional MRI) and neuropsychological long term changes in moderate drowning victim's compared to healthy volunteers in working memory and motor domains. We studied 15 adult drowning victim's in chronic stage (DV - out of 157 eligible cases of sea water rescues with moderate drowning classification) paired to 18 healthy controls (HC). All participants were investigated using intelligence, memory, and attention neuropsychological standard tests and underwent functional (motor and working memory tasks) and structural magnetic resonance imaging (MRI) in a 3 T system. All images were preprocessed for head movement correction and quantitative analysis was performed using FSL and freesurfer software packages. We found no between group differences in neuropsychological assessments. No MRI brain lesion was observed in patients, neither difference on morphometric parameters in any cortical or subcortical brain structure. In constrast, functional MRI revealed that patients showed increased brain response in the motor (left putamen and insula) and memory (left cuneus and lingual gyrus - not the classical memory network) tasks. Functional brain changes in motor and visual brain regions in victims of moderate drowning may indicate reduced brain reserve, despite the lack of structural and behavior alterations. More attention should be given to investigate ageing effects in this nonfatal drowning group.
authors.affiliation: LIM-44 (NIF - Neuroimagem Funcional), Departamento de Radiologia, Faculdade de Medicina da Universidade de São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, s/n 3o andar. Cerqueira César, São Paulo, SP, Brazil. nuccimar@gmail.com.
authors.forename: Mariana P
authors.initials: MP
authors.lastname: Nucci
authors.affiliation: LIM-44 (NIF - Neuroimagem Funcional), Departamento de Radiologia, Faculdade de Medicina da Universidade de São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, s/n 3o andar. Cerqueira César, São Paulo, SP, Brazil.
authors.forename: Katerina
authors.initials: K
authors.lastname: Lukasova
authors.affiliation: Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, SP, Brazil.
authors.forename: João R
authors.initials: JR
authors.lastname: Sato
authors.affiliation: LIM-44 (NIF - Neuroimagem Funcional), Departamento de Radiologia, Faculdade de Medicina da Universidade de São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, s/n 3o andar. Cerqueira César, São Paulo, SP, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Amaro
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D001930:Brain Injuries / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology; D001931:Brain Mapping; D005260:Female; D005385:Fingers / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D015701:Near Drowning / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D009483:Neuropsychological Tests; D009929:Organ Size; D011930:Reaction Time; D055815:Young Adult
keywords: Drowning; Functional magnetic resonance imaging; Hypoxia brain; Motor activity; Neuropsychological tests; Working memory