Brain MRI after critical care admission: A longitudinal imaging study

Area of Science:

• Neuroscience
• Gerontology
• Radiology

Background:

• Older adults are susceptible to cognitive decline.
• Critical care hospitalizations and delirium are potential risk factors for brain changes.

Purpose of the Study:

• To examine the association between critical care hospitalizations, delirium, and structural brain changes in older adults.
• To determine if intensive care unit (ICU) admission impacts brain structure and amyloid deposition.

Main Methods:

• Utilized brain MRI and amyloid PET scans from the Mayo Clinic Study of Aging participants (≥60 years).
• Hypothesized ICU admission leads to cortical thinning and atrophy in specific brain regions, accelerated by delirium.
• Assessed if ICU admission correlates with increased cortical amyloid.

Main Results:

• ICU admission correlated with cortical thinning (temporal, frontal, parietal) and reduced hippocampal/corpus callosum volumes.
• Delirium significantly amplified these brain changes following ICU admission.
• No association found between ICU admission and increased cortical amyloid burden.

Conclusions:

• Critical care hospitalization accelerates brain atrophy in specific regions in older adults.
• The observed neurodegeneration appears unrelated to the Alzheimer's disease amyloid pathway.
• Delirium exacerbates brain structure changes post-ICU admission.