Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Aligning Acute and Chronic Functional Readouts and utilizing Zolpidem to improve Neurological Impairments after Cardiac Arrest

Fine, David (2020) Aligning Acute and Chronic Functional Readouts and utilizing Zolpidem to improve Neurological Impairments after Cardiac Arrest. Master's Thesis, University of Pittsburgh. (Unpublished)

Download (2MB) | Preview


While cardiac arrest survival rates have improved alongside recent advances in modern resuscitation techniques and targeted temperature management, many survivors experience multiple ongoing symptoms after their hypoxic-ischemic brain injury (HIBI) including movement disorders, depression, and low cognitive arousal. Neurological assessments like the neurological deficit score (NDS), and physiological readouts from blood chemistry values are used to assess acute post-injury outcome, but little has been done to evaluate how these acute readouts distinguish heterogeneity within the injury population, or how they align with long term behavioral and neurological outcomes as a prognostic tool. Recent evidence also highlights zolpidem as an effective treatment for post-HIBI symptoms, but its clinical use has been met with mixed results. This study utilized a regression model and correlational analyses to evaluate associations among NDS, blood lactate, and blood acid base excess values as acute post-injury readouts, behavioral outcome, and dopamine neurotransmission outcomes obtained via fast scan cyclic voltammetry two weeks after a 5-min asphyxia cardiac arrest (ACA). A pilot study was also performed to evaluate the effects of chronic systemic zolpidem administration on improving behavioral outcomes and reversing striatal hyper-dopaminergia after ACA. NDS significantly aligned with survival probability after ACA. NDS and both blood chemistry readouts aligned with several behavioral and dopamine neurotransmission outcomes, and several dopaminergic and behavioral outcomes robustly correlated with one another. Additionally, chronic zolpidem reflexive and cognitive behavioral outcomes, as defined by the acoustic startle response and the sucrose preference test, respectively. This work highlights novel associations between post-HIBI behavioral and neurological outcomes as well as benefits of chronic zolpidem administration in ameliorating post-HIBI neurological sequelae. Future work should further characterize the effects of zolpidem administration after cardiac arrest and utilize molecular assays to identify protein expression changes that will unravel neurobiological mechanisms driving HIBI-induced functional impairments and highlight therapeutic targets to treat CA survivors.


Social Networking:
Share |


Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Fine, Daviddfine64@gmail.comdff21
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMeriney,
Committee MemberDixon,
Committee MemberWagner,
Date: 16 September 2020
Date Type: Publication
Defense Date: 22 June 2020
Approval Date: 16 September 2020
Submission Date: 27 July 2020
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 87
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Neuroscience
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: cardiac arrest, ischemia, zolpidem, dopamine
Date Deposited: 16 Sep 2020 15:57
Last Modified: 16 Sep 2020 15:57


Monthly Views for the past 3 years

Plum Analytics

Actions (login required)

View Item View Item