SYNAPTIC

  • Research type

    Research Study

  • Full title

    SYNAPTIC (StudY of Neurocognitive Associated Pathological and Transcriptomic Implications of Critical illness)

  • IRAS ID

    299788

  • Contact name

    Zoeb Jiwaji

  • Contact email

    zoeb.jiwaji@ed.ac.uk

  • Sponsor organisation

    University of Edinburgh

  • Duration of Study in the UK

    2 years, 0 months, 1 days

  • Research summary

    Cognitive impairment following critical illness is common and associated with significant harm. 34% of survivors admitted with non-neurological diagnoses (and with no pre-existing cognitive problems) are left with mental deficits equivalent to or greater than mild Alzheimer’s disease or moderate traumatic brain injury. Unfortunately, the mechanisms underlying critical-illness cognitive dysfunction are incompletely understood and there remains no effective treatment.

    As the brain is a very inaccessible organ, much of our fundamental understanding comes from animal studies, which may not translate well to processes occurring in our patients. SYNAPTIC hopes to address this gap through the use of post-mortem brain biopsies on patients who have died following critical illness.

    The study will recruit participants who are approaching death in the intensive therapy unit (ITU), and for whom there is family and treating team consensus to proceed to stopping life-sustaining treatment. Brain biopsies will be carried out shortly following death which will provide tissue to be analysed using novel single-cell transcriptomic approaches. The data from this will be combined with blood samples taken just before death and brain fluid samples taken just after death, along with the high-resolution physiological and medical data which is routinely gathered as part of normal critical illness care.

    The primary aim will be to examine differences in the brains between patients with evidence of active inflammation (measured by raised inflammatory markers and fever) vs those without. Beyond this, we hope this approach will also improve our broader understanding of the fundamental brain biology underlying ITU brain dysfunction and offer insight into mechanisms that could subsequently be targeted for therapeutic benefit.

  • REC name

    Scotland A: Adults with Incapacity only

  • REC reference

    22/SS/0037

  • Date of REC Opinion

    11 Jul 2022

  • REC opinion

    Further Information Favourable Opinion