Hippocampal Volume and Memory Functions in Aneurysmal Subarachnoid Hemorrhage
- Conditions
- Subarachnoid Hemorrhage, AneurysmalNeurologic Disorder
- Interventions
- Diagnostic Test: Neuropsychological assessment and structural MRI
- Registration Number
- NCT04449666
- Lead Sponsor
- BDH-Klinik Hessisch Oldendorf
- Brief Summary
Neuropsychological and functional long-term consequences of subarachnoid hemorrhages (SAH) represent a great challenge, since sometimes considerable cognitive deficits occur without evidence of substantial brain damage. In this study, we want to examine if the frequently observed memory deficits are associated with hippocampal atrophy.
- Detailed Description
Long-term or even permanent neuropsychological impairments are frequently observed after aneurysmal subarachnoid hemorrhages (aSAH). Among the most common impairments after aSAH are memory deficits. Volumetric MRI studies suggest an association of memory dysfunctions with temporal atrophy, especially of the hippocampus. In a previous study, 77 patients with good or moderate clinical outcome after aSAH were examined one year after discharge (Bendel et al., 2006). Temporomesial atrophy was detected without direct brain damage, e.g. by secondary ischemia. Due to the effects of complex cognitive impairments on the quality of life and participation in social and professional life, this relationship will be examined in more detail in the planned study. Specifically, we will investigate to what extent the frequently observed discrepancy between severe memory impairment and normal structural imaging results (no focal lesions in temporomesial areas) is due to hippocampal atrophy. In contrast to Bender and colleagues, this question will be investigated in the acute phase of the disease, immediately after admission to inpatient neurological rehabilitation.
Over a period of 24 months, 29 neurological rehabilitation patients with aSAH (Hunt \& Hess grade I and II) are going to be included. Within the first week (day 1 to 7) after study enrollment, a native MRI examination (without contrast agent) is performed, in which a high-resolution 3D-MPRAGE sequence (T1 weighting) is measured in the sagittal plane. After checking the data quality of the 3D-MPRAGE sequence, especially with regard to its suitability for hippocampal volume determination, a comprehensive neuropsychological examination is performed, in which specific memory and attentional functions are tested.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 30
- neurological rehabilitation patients in phase B - D
- at minimum eight weeks after disease onset
- aneurysmal subarachnoid hemorrhage (Hunt & Hess grade I or II)
- written consent from the patient's legal representative
- exclusion of pregnancy
- insufficient cardiorespiratory stability
- previous brain damage
- mental disorders (dementia, depression)
- colonization with multi-resistant pathogens
- MRI contraindications
- claustrophobia
- weight > 120 kg
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Experimental group Neuropsychological assessment and structural MRI Patients undergoing neurological rehabilitation after aneurysmal subarachnoid hemorrhage Control group Neuropsychological assessment and structural MRI Healthy adults controlled for age, gender and educational status
- Primary Outcome Measures
Name Time Method Changed hippocampal volume in aSAB 2 weeks Hypothesis: patients have smaller hippocampal volume than healthy control subjects. For the hippocampal volume a structural MRI scan (3D-MPRAGE) is obtained
- Secondary Outcome Measures
Name Time Method Influence of the lesion site on the hippocampal volume 2 weeks Hypothesis: there are no differences between ispi- and contralateral hippocampal volumes
Changed intracranial volume in aSAB 2 weeks Hypothesis: patients have smaller intracranial volume than healthy control subjects.
Changed memory function in aSAB 2 weeks Hypothesis: patients have lower scores in the Visual and Verbal memory test (VVM) than healthy control subjects.
Influence of the type of therapy on the hippocampal volume 2 weeks Hypothesis: hippocampal volumes differ between aSAH patients with surgical or endovascular treatment.
Interrater reliability 2 weeks Hypothesis: It is expected that there will be no difference in the ratings of hippocampal volume between two independent raters.
Trial Locations
- Locations (1)
BDH-Clinic Hessisch Oldendorf
🇩🇪Hessisch Oldendorf, Germany