Cognition function after Drowning: a functional MRI study
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conferenceObject
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2012
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INFORMA HEALTHCARE
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BRAIN INJURY, v.26, n.4-5, p.434-435, 2012
Resumo
Objective: The aim of this ongoing study is to investigate cerebral activity in drowning subjects for specific tasks involving memory, attention and motor functions by means of fMRI. Methods: Ten drowning survivors subjects (DS; 6 women) with mean age of 25.8 (SD=7.4) and 10 healthy controls (HC: 6 women) with mean age of 26.3 (SD=5.3), were studied. We used a blocked fMRI paradigm, in three tasks: working memory (WM condition A-complex figures and B-fixation cross), word-color stroop task (ST condition A- congruent word-ink, B incongruent word-ink and C-neutral word) and motor tasks (motor condition A-right hand finger tapping, B-left hand finger tapping and C-rest). The BOLD images (GRE-EPI) were acquired on a 3 T scanner (Philips Achieva), 8Ch head coil with integrated MRI compatible Eye Tracker (Magconcept), synchronized with the image acquisition. TR was 2 s, TE=30 ms, voxels size 3x3x3mm. Images were analyzed using FSL software. Preprocessing included motion correction/ T1 effect, spatial smoothing, transformation of image into standard space and nonparametric analyses. The activation maps were obtained considering Z-voxel > 2.3 and cluster-wise p-value < 0.05. The analysis of interest was to compare conditions: DS versus HC for each paradigm and between each condition involved in the tasks. The WM condition A > B, motor A > C and B > C and stroop condition A > C and B > C. Behavioral data in WM was analyzed for accuracy and reaction time. Results: The DS mean accuracy/response time in the WM task was 72.6% ± 16.5%/57.4% ± 6.9% compared to 76.3% ± 10.1%/ 52.0% ± 4.9% in HC DS group maps of WM showed reduced BOLD effect in the major areas involved the working memory circuitry (cerebellum, occipital cortex, inferior frontal gyrus, bilateral parietal cortex, and frontal regions) than HC. In motor task positive BOLD effect was less pronounced in the DS in supplementary motor area, and the patients showed only contralateral activation. There was a large variation in the ST, and only in individual maps showed BOLD effect in each group. Conclusions: These preliminary findings show a difference in brain activity in subjects that suffered drowning injuries, more evident in memory and motor tasks, but the number of patients is insufficient for conclusion. Interesting enough, their behavior analysis in memory task was not different, suggesting that the cognitive processes require different areas to produce the same output. We are continuing data acquisition, but due to the high mortality, finding volunteers still represents one important challenge for this study.