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Value of Biomarkers of Brain Injury for Predicting Psycho-cognitive Sequelae Secondary to Sepsis: a Prospective Multicenter Study (SEPSYM)

3. august 2026 opdateret af: Assistance Publique - Hôpitaux de Paris
To evaluate the value of biomarkers of neuronal and glial injury for predicting cognitive impairment (memory impairment assessed by a MoCA score < 26/30) at 3 months in patient admitted in the intensive care unit for a sepsis or a septic shock.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Sepsis is a major cause of admission to intensive care units and is responsible for approximately 11 million deaths worldwide each year. It may be complicated by an acute brain dysfunction known as sepsis-associated encephalopathy (SAE), which affects about 50% of patients and typically manifests as delirium or coma. The diagnosis of SAE is primarily clinical, with EEG and brain MRI providing supportive information. Risk factors for SAE are mainly related to patient characteristics, including advanced age, chronic kidney disease, and pre-existing neurodegenerative or cognitive disorders. The pathophysiology of SAE involves three major mechanisms: neuroinflammation, endothelial dysfunction with blood-brain barrier disruption, and mitochondrial dysfunction leading to neuronal injury. These mechanisms likely explain both acute neurological symptoms and long-term psycho-cognitive sequelae. Following sepsis, 30-60% of patients develop psychiatric disorders and cognitive impairments comparable to those observed after moderate traumatic brain injury or early Alzheimer's disease. These sequelae are part of post-intensive care syndrome (PICS), supporting the need for structured post-ICU follow-up. However, the optimal target population and organization of such follow-up remain unclear, as some studies have reported reduced quality of life in patients receiving long-term follow-up. Identifying early biomarkers predictive of psycho-cognitive outcomes is therefore crucial, as current data on neuronal and glial biomarkers remain limited. Such biomarkers could improve prognostication, guide cognitive rehabilitation and psychological support, and contribute to the development of future neuroprotective strategies.

Primary objective:

To evaluate the value of biomarkers of brain injury for predicting cognitive impairment (memory impairment assessed by a MoCA score < 26/30) at 3 months.

Secondary objectives:

  • To evaluate the value of brain injury biomarkers for predicting delirium in the ICU, including hypoactive, hyperactive, and mixed phenotypes
  • To assess the association between brain injury biomarkers and the duration of delirium in the ICU
  • To evaluate the value of brain injury biomarkers for predicting psychological sequelae (anxiety, post-traumatic stress disorder, and depression) at 3 months
  • To evaluate the value of brain injury biomarkers for predicting functional neurological outcomes using the Glasgow Outcome Scale-Extended at ICU discharge and at 3 months
  • To assess the association between brain injury biomarkers and Post-Intensive Care Syndrome (PICS)
  • To assess the association between brain injury biomarkers and EEG abnormalities in the ICU
  • To assess the association between brain injury biomarkers and MRI abnormalities at 3 months

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

210

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Frankrig
    • Île-de-France Region
      • Paris, Île-de-France Region, Frankrig, 75014
        • Hôpital Cochin - APHP Centre
        • Kontakt:

Deltagelseskriterier

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Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adults aged 18-80 years.
  • Admission to a medical or mixed ICU.
  • Sepsis or septic shock according to Sepsis-3 criteria.
  • ICU admission for less than 24 hours.
  • Need for invasive or non-invasive mechanical ventilation and/or vasopressor support.
  • Informed consent obtained from the patient or legal representative.

Exclusion Criteria:

  • Moribund patients.
  • Age >80 years.
  • Patients under legal guardianship.
  • History of schizophrenia or bipolar disorder.
  • Pregnancy.
  • No health insurance coverage.
  • Previous inclusion in the study.
  • Refusal to participate.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Diagnostisk
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Cognitive function impairment assessed by the Montreal Cognitive Assessment (MoCA) score at 3 months
Tidsramme: 3 months
Montreal Cognitive Assessment (MoCA) ranges from 0 to 30 points, with higher scores indicating better cognitive performance. Cognitive impairment will be defined as a MoCA score <26/30.
3 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Coma- and/or delirium-free days
Tidsramme: Day 10 after inclusion
Day 10 after inclusion
Duration of delirium in the intensive care unit (ICU)
Tidsramme: 3 months
3 months
Type of ICU delirium: hypoactive, hyperactive, or mixed
Tidsramme: 3 months
3 months
Psychiatric disorders (anxiety, depression : ( 0 =min; 21 =max) , or PTSD)
Tidsramme: 3 months
3 months
Glasgow Outcome Scale-Extended (GOSE)
Tidsramme: 3 months
3 months
Delirium duration
Tidsramme: 3 months
Number of ICU days with delirium assessed using the Confusion Assessment Method for the ICU (CAM-ICU). Delirium duration will be reported as the cumulative number of ICU days with at least one positive CAM-ICU assessment. Higher values indicate longer delirium duration.
3 months
Delirium phenotype
Tidsramme: 3 months
ICU delirium phenotype classified as hypoactive, hyperactive or mixed according to CAM-ICU and RASS assessments. Results will be reported as the proportion of patients in each category.
3 months
Psychiatric outcomes
Tidsramme: 3 months
Symptoms of anxiety and depression assessed using the Hospital Anxiety and Depression Scale (HADS; higher scores indicate greater symptom severity). PTSD assessed using the PTSD Checklist (PCL-5). Results will be reported as continuous scores and proportions of patients above validated thresholds
3 months
Functional outcome
Tidsramme: 3 months
Functional neurological outcome assessed using the Glasgow Outcome Scale-Extended (GOSE; range 1-8, higher scores indicate better functional recovery).
3 months
PICS : Post-Intensive Care Syndrome (PICS)
Tidsramme: 3 months
PICS is defined by the presence of cognitive impairment, psychiatric symptoms and/or physical disability at 3 months. Results will be reported as the proportion of patients fulfilling at least one PICS domain.
3 months
Neurological, psychiatric, or rehabilitation follow-up proposed to the patient
Tidsramme: 3 months
Referral for specialized follow-up after ICU discharge. This outcome will be reported as the proportion of patients referred to neurological consultation, psychiatric consultation, cognitive rehabilitation, physical rehabilitation and/or a multidisciplinary post-ICU clinic.
3 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Assistance Publique - Hôpitaux de Paris

Samarbejdspartnere

URC-CIC Paris Descartes Necker Cochin
ANR and Ministry of Health

Efterforskere

  • Ledende efterforsker: Sarah BENGHANEM, Dr, Assistance Publique - Hôpitaux de Paris

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

1. maj 2028

Studieafslutning (Anslået)

1. august 2028

Datoer for studieregistrering

Først indsendt

26. marts 2026

Først indsendt, der opfyldte QC-kriterier

3. august 2026

Først opslået (Faktiske)

4. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

3. august 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • APHP251947
  • IDRCB (Anden identifikator: 2025-A02589-40)

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