04-Association of Plasma Insulin Growth Factor to Memory and Cognition 12 Months After Aneurysmal SAH
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Neuroscience, Research, 2021
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The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Elizabeth A. Crago

Introduction/Hypothesis: Cognitive impairments often burden survivors of aneurysmal subarachnoid hemorrhage (aSAH). Insulin growth factor (IGF1) is a potent cellular growth-promoting factor with links to memory and cognitive performance and demonstrated independent neuroprotective actions in stroke and neurologic disease. This study sought to examine the relationship between plasma IGF1 levels and cognitive performance in measures of executive function, learning and memory 12 months after aSAH.

Methods: This cohort of 130 aSAH survivors enrolled in an NIH study (NR004339, NR018160) was 54.1 years (SD 10.03) and female (79%) with a mean World Federation Neurological Scale (WFNS) 1.8 (1 = 58.5%; 2 = 20.8). Plasma samples were collected daily 0-14 days after aSAH and banked in a biorepository. Mean plasma IGF1 concentrations were derived from 1221 plasma samples using a commercial sandwich solid-phase ELISA kit. Neuropsychological assessments were evaluated 12 months after aSAH. Descriptives, Spearman correlations and linear regression analyses were completed using SPSS and SAS.

Results: Older age was significantly associated with lower mean plasma IGF1 levels (r = -.418, p<.001). Lower mean IGF1 levels were associated with worse performance in memory measures [Tay copy (r = .215, p=.02); Tay immediate (r =.333, p<.001) and Tay delay recall (r =.318, p<.001)] and working memory sequence (r =.367, p=.04), as well as measures of attention (trails A time r = -.193, p=.03) and mental flexibility (Trails B r = -.25, p=.01). In linear regression models controlling for age and WFNS, mean IGF1 levels remained significantly associated with worse performance on tests of memory (Tay copy p=.02, Tay immediate p=.02, Tay delay p=.002, and working memory sequence p=.05); as well as attention (Trails A p=.02) and language (color word association p=.05).

Conclusions: IGF1 levels have not been well characterized after aSAH. These results suggest lower plasma IGF1 after hemorrhage are associated with poor performance on tests of memory and executive function 12 months after aSAH and provide impetus for future work to further examine these relationships and to inform possible interventions aimed at improving long-term aSAH outcomes.


Meta Tag
Content Type Presentation
Knowledge Area Neuroscience
Knowledge Area Research
Knowledge Level Advanced
Membership Level Select
Tag Subarachnoid Hemorrhage
Tag Outcomes Research
Year 2021
Elizabeth Crago
plasma IGF-1 levels
subarachnoid hemorrhage


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