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Brain injury after moderate drowning: subtle alterations detected by functional magnetic resonance imaging

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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.

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Abbreviations

BOLD:

blood oxygem level-dependent

fMRI:

functional magnetic resonance image

MRI:

magnetic resonance image

GLM:

general linear model

FT:

finger tapping

WM:

working memory

DV:

drowning victims

HC:

healthy control

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Acknowledgments

This work was supported by grant 2005/56464-9, São Paulo Research Foundation (FAPESP), São Paulo (SP), Brazil and LIM-44, Department of Radiology, Faculty of Medicine, University of São Paulo (USP), São Paulo (SP), Brazil.

Author contributions

Guarantor of integrity of the entie study: Nucci MP, Lukasova K and Amaro E. Design or conceptualization of the study: Nucci MP, Lukasova K, Sato JR and Amaro E. Literature research: Nucci MP. Analysis or interpretation of the data: Nucci MP, Lukasova K, Sato JR and Amaro E. Drafting or revising the manuscript for intellectual content: Nucci MP, Lukasova K, Sato JR and Amaro E.

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Authors and Affiliations

  1. 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

    Mariana P. Nucci, Katerina Lukasova & Edson Amaro Jr

  2. Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, SP, Brazil

    João R. Sato

Authors
  1. Mariana P. Nucci
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  2. Katerina Lukasova
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  3. João R. Sato
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  4. Edson Amaro Jr
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Corresponding author

Correspondence to Mariana P. Nucci.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All participants provided informed written consent, and the study was approved by the Ethics Committee of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (in 29/03/2007 – no. 0004/07).

Conflict of interest

Mariana P Nucci, Katerina Lukasova, João R Sato and Edson Amaro declare that they no confict of interest.

Informed consent

All procedures followed were in accordance with the ethnical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964. Informed consent was obtained from all participants for being included in the study.

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Nucci, M.P., Lukasova, K., Sato, J.R. et al. Brain injury after moderate drowning: subtle alterations detected by functional magnetic resonance imaging. Brain Imaging and Behavior 11, 1412–1421 (2017). https://doi.org/10.1007/s11682-016-9619-1

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