Cortical thinning in bvFTD patients.

<p>Results of the comparison of cortical thickness between patients with behavioural variant frontotemporal dementia and healthy controls. Results are from the Freesurfer analysis, results of the general linear model analysis were corrected for multiple comparisons at the cluster level using the Monte Carlo method for p-cluster at <i>p</i> < 0.01 (z-vertex 2.0). No nuisance variables were entered into the model. Coloured areas represent areas of significant differences, where warmer colours represent cortical thickening and cooler colours cortical thinning. Scale bar represents <i>p</i> on a logarithmic scale. The upper row is the right hemisphere, the lower row is left hemisphere, from lateral, medial and inferior views.</p

Graphical representations of the tracts studied.

<p>Sagittal (upper) and coronal (lower) view. The uncinate fasciculus (green), the anterior cingulum (orange), the inferior frontooccipital fasciculus (light blue) and the forceps minor (dark blue). Tracts are from TrackVis, overlaid on high resolution images for illustrative purposes.</p

Frontal Behavioural Inventory and FA of tracts.

<p>Scatter plots of Frontal Behavioural Inventory composite score of items 12–22 (FBI^12-22) and fractional anisotropy (FA) of tracts in patients with behavioural variant frontotemporal dementia (bvFTD) (dots) and progressive supranuclear palsy (PSP) (triangles), for A: the right uncinate fasciculus, B: the left uncinate fasciculus, C: the anterior cingulum and D: the forceps minor. B (adjusted) and <i>p</i> are derived from the linear regression model, with age as covariate.</p

Fractional anisotropy and Hayling error score correlations.

<p>Scatter plots of total error score on the Hayling test and fractional anisotropy (FA) of tracts in patients with behavioural variant frontotemporal dementia (dots) and progressive supranuclear palsy (triangles), for A: the right uncinate fasciculus, B: the right anterior cingulum, and C: the forceps minor. B (adjusted) and <i>p</i> are derived from the linear regression model, with age as covariate.</p

Demographic and clinical data of subjects.

<p>Demographic and clinical data of subjects.</p

Cortical thickness and Hayling error score correlations.

<p>Correlations between cortical thickness and total error score on the Hayling test in patients with behavioural variant frontotemporal dementia and progressive supranuclear palsy using Freesurfer. Correction for multiple comparisons was made using the Monte Carlo method at the cluster level, at <i>p</i> < 0.01 (z-vertex 1.3). Age was entered as a nuisance variable. Coloured areas represent significant negative correlations, with the scale bar representing <i>p</i> on a logarithmic scale. Only the right hemisphere is shown, from lateral, medial and inferior views. No regions with significant correlation with cortical thickness were detected in the left hemisphere.</p

Boxplots of FA values of tracts studied.

<p>HC: healthy controls, PSP: progressive supranuclear palsy, bvFTD: behavioural variant frontotemporal dementia. FA: fractional anisotropy. FM: forceps minor, UF: uncinate fasciculus, IFOF: inferior frontooccipital fasciculus, aCi: anterior cingulum. Rh: right hemisphere and lh: left hemisphere. Boxes represent 25^th and 75^th percentile with median, whiskers minimum and maximum value. Staples represent statistically significant differences in between group pairs, at <i>p</i> < 0.05, uncorrected for multiple comparisons.</p

Effects of hypothermia vs normothermia on societal participation and cognitive function at 6 months in survivors after out-of-hospital cardiac arrest

Importance: The Targeted Hypothermia vs Targeted Normothermia After Out-of-Hospital Cardiac Arrest (TTM2) trial reported no difference in mortality or poor functional outcome at 6 months after out-of-hospital cardiac arrest (OHCA). This predefined exploratory analysis provides more detailed estimation of brain dysfunction for the comparison of the 2 intervention regimens. Objectives: To investigate the effects of targeted hypothermia vs targeted normothermia on functional outcome with focus on societal participation and cognitive function in survivors 6 months after OHCA. Design, Setting, and Participants: This study is a predefined analysis of an international multicenter, randomized clinical trial that took place from November 2017 to January 2020 and included participants at 61 hospitals in 14 countries. A structured follow-up for survivors performed at 6 months was by masked outcome assessors. The last follow-up took place in October 2020. Participants included 1861 adult (older than 18 years) patients with OHCA who were comatose at hospital admission. At 6 months, 939 of 1861 were alive and invited to a follow-up, of which 103 of 939 declined or were missing. Interventions: Randomization 1:1 to temperature control with targeted hypothermia at 33 °C or targeted normothermia and early treatment of fever (37.8 °C or higher). Main outcomes and measures: Functional outcome focusing on societal participation assessed by the Glasgow Outcome Scale Extended ([GOSE] 1 to 8) and cognitive function assessed by the Montreal Cognitive Assessment ([MoCA] 0 to 30) and the Symbol Digit Modalities Test ([SDMT] z scores). Higher scores represent better outcomes.ResultsAt 6 months, 836 of 939 survivors with a mean age of 60 (SD, 13) (range, 18 to 88) years (700 of 836 male [84%]) participated in the follow-up. There were no differences between the 2 intervention groups in functional outcome focusing on societal participation (GOSE score, odds ratio, 0.91; 95% CI, 0.71-1.17; P = .46) or in cognitive function by MoCA (mean difference, 0.36; 95% CI,−0.33 to 1.05; P = .37) and SDMT (mean difference, 0.06; 95% CI,−0.16 to 0.27; P = .62). Limitations in societal participation (GOSE score less than 7) were common regardless of intervention (hypothermia, 178 of 415 [43%]; normothermia, 168 of 419 [40%]). Cognitive impairment was identified in 353 of 599 survivors (59%).ConclusionsIn this predefined analysis of comatose patients after OHCA, hypothermia did not lead to better functional outcome assessed with a focus on societal participation and cognitive function than management with normothermia. At 6 months, many survivors had not regained their pre-arrest activities and roles, and mild cognitive dysfunction was common.</p