Hyperconnectivity of the default mode network in multiorgan dysfunction syndrome

Multiple Organ Dysfunction Syndrome (MODS) is a systemic physiological disorder affecting two or more body organs triggered after an insult complication. Beyond the systemic failure, patients who survive MODS present cognitive and neurological impairments that remain stable even several years after Intensive Care Unit (ICU) discharge. Here, we focus on the specific situation of MODS patients with no apparent brain damage (NABD), where the mechanisms driving cognitive impairment at long term are not well-understood. We recruit N1 = 13 MODS patients with NABD at 6 months after ICU discharge, together with N2 = 13 healthy controls (matched by age, sex and years of education), and acquire functional magnetic resonance imaging at rest to find that, as compared to control, MODS patients with NABD present an overall increase of the functional connectivity (FC) at rest. In particular, we find that the default mode network (DMN) hyperconnects (increasing the node strength of the FC matrix) to three classes of networks: primary sensory (such as auditory, sensory-motor and visual), multimodal integration (such as dorsal attention and salience) and higher order cognition networks (such as fronto-parietal, language and executive control). Therefore, although these patients do not have an apparent structural damage after MODS, at the functional level, we found brain network alterations coexisting with hyperconnectivity of the DMN, that similar to what happens at the onset of other pathologies, might indicate a possible mechanism for brain compensation occurring after MODS.