Refine
Has Fulltext
- yes (11)
Is part of the Bibliography
- yes (11)
Year of publication
Document Type
- Journal article (11)
Language
- English (11)
Keywords
- cerebellar tDCS (2)
- multiple sclerosis (2)
- split-belt treadmill (2)
- 3D fluoroscopy (1)
- Alemtuzumab (1)
- Arterial Diameters (1)
- B cells (1)
- Brain atrophy (1)
- CD52 (1)
- CNS (1)
- CNS imaging (1)
- Chronic heart failure (1)
- Cognitive decline (1)
- EAE (1)
- GFAP (1)
- Glial fibrillary acidic protein (1)
- MS (1)
- Medizin (1)
- Memory dysfunction (1)
- Parkinson’s disease (1)
- aneurysm surgery (1)
- angiography (1)
- balance (1)
- blood flow (1)
- central nervous system (1)
- cerebral arteries (1)
- cervical dystonia (1)
- cholinergic activity (1)
- chronic heart failure (1)
- clip control (1)
- cluster analysis (1)
- cognitive impairment (1)
- consolidation (1)
- continuous theta burst stimulation (cTBS) (1)
- contrast (1)
- cortical excitability (1)
- cortical silent period (1)
- fibromyalgia syndrome (1)
- functional MRI (1)
- gait (1)
- glial fibrillary acidic protein (1)
- image quality (1)
- intensity of attention (1)
- intraoperative (1)
- ischemic stroke (1)
- lesions (1)
- levodopa-induced dyskinesia (1)
- locomotor adaptation (1)
- magnetic resonance imaging (1)
- motor-evoked potentials (MEP) (1)
- peripheral nerve involvement (1)
- post-processing (1)
- renal system (1)
- risk of fall (1)
- stroke (1)
- transcranial magnetic simulation (TMS) (1)
- vessel patency (1)
Institute
- Neurologische Klinik und Poliklinik (10)
- Institut für diagnostische und interventionelle Neuroradiologie (ehem. Abteilung für Neuroradiologie) (9)
- Deutsches Zentrum für Herzinsuffizienz (DZHI) (2)
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie (2)
- Institut für Anatomie und Zellbiologie (1)
- Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik) (1)
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (1)
- Klinik und Poliklinik für Nuklearmedizin (1)
- Klinik und Poliklinik für Strahlentherapie (1)
- Medizinische Klinik und Poliklinik I (1)
Sonstige beteiligte Institutionen
Background
Cognitive impairment is a major comorbidity in patients with chronic heart failure (HF) with a wide range of phenotypes. In this study, we aimed to identify and compare different clusters of cognitive deficits.
Methods
The prospective cohort study “Cognition.Matters-HF” recruited 147 chronic HF patients (aged 64.5 ± 10.8 years; 16.2% female) of any etiology. All patients underwent extensive neuropsychological testing. We performed a hierarchical cluster analysis of the cognitive domains, such as intensity of attention, visual/verbal memory, and executive function. Generated clusters were compared exploratively with respect to the results of cardiological, neurological, and neuroradiological examinations without correction for multiple testing.
Results
Dendrogram and the scree plot suggested three distinct cognitive profiles: In the first cluster, 42 patients (28.6%) performed without any deficits in all domains. Exclusively, the intensity of attention deficits was seen in the second cluster, including 55 patients (37.4%). A third cluster with 50 patients (34.0%) was characterized by deficits in all cognitive domains. Age (p = 0.163) and typical clinical markers of chronic HF, such as ejection fraction (p = 0.222), 6-min walking test distance (p = 0.138), NT-proBNP (p = 0.364), and New York Heart Association class (p = 0.868) did not differ between clusters. However, we observed that women (p = 0.012) and patients with previous cardiac valve surgery (p = 0.005) prevailed in the “global deficits” cluster and the “no deficits” group had a lower prevalence of underlying arterial hypertension (p = 0.029). Total brain volume (p = 0.017) was smaller in the global deficit cluster, and serum levels of glial fibrillary acidic protein were increased (p = 0.048).
Conclusion
Apart from cognitively healthy and globally impaired HF patients, we identified a group with deficits only in the intensity of attention. Women and patients with previous cardiac valve surgery are at risk for global cognitive impairment when suffering HF and could benefit from special multimodal treatment addressing the psychosocial condition.