Article (Scientific journals)
Brain gray matter MRI morphometry for neuroprognostication after cardiac arrest
Silva, Stein; Peran, Patrice; Kerhuel, Lionel et al.
2017In Critical Care Medicine, 45 (8), p. 763-e771
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Keywords :
Article; Belgium; France; Italy; Adult; Brain; Cerebellar Cortex; Coma; Female; Gray Matter; Heart Arrest; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Prognosis; Prospective Studies
Abstract :
[en] Objectives: We hypothesize that the combined use of MRI cortical thickness measurement and subcortical gray matter volumetry could provide an early and accurate in vivo assessment of the structural impact of cardiac arrest and therefore could be used for long-term neuroprognostication in this setting. Design: Prospective cohort study. Setting: Five Intensive Critical Care Units affiliated to the University in Toulouse (France), Paris (France), Clermont-Ferrand (France), Liège (Belgium), and Monza (Italy). Patients: High-resolution anatomical T1-weighted images were acquired in 126 anoxic coma patients ("learning" sample) 16 ± 8 days after cardiac arrest and 70 matched controls. An additional sample of 18 anoxic coma patients, recruited in Toulouse, was used to test predictive model generalization ("test" sample). All patients were followed up 1 year after cardiac arrest. Interventions: None. Measurements and Main Results: Cortical thickness was computed on the whole cortical ribbon, and deep gray matter volumetry was performed after automatic segmentation. Brain morphometric data were employed to create multivariate predictive models using learning machine techniques. Patients displayed significantly extensive cortical and subcortical brain volumes atrophy compared with controls. The accuracy of a predictive classifier, encompassing cortical and subcortical components, has a significant discriminative power (learning area under the curve = 0.87; test area under the curve = 0.96). The anatomical regions which volume changes were significantly related to patient's outcome were frontal cortex, posterior cingulate cortex, thalamus, putamen, pallidum, caudate, hippocampus, and brain stem. Conclusions: These findings are consistent with the hypothesis of pathologic disruption of a striatopallidal-thalamo-cortical mesocircuit induced by cardiac arrest and pave the way for the use of combined brain quantitative morphometry in this setting. Copyright © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Disciplines :
Neurology
Author, co-author :
Silva, Stein;  Department of Anaesthesiology and Critical Care, Critical Care Unit, University Teaching Hospital of Purpan, Place du Dr Baylac, Toulouse Cedex 9, France, Critical Care and Anaesthesiology Department, University Teaching Hospital of Purpan, Place du Dr Baylac, Toulouse Cedex 9, France, Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Peran, Patrice;  Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Kerhuel, Lionel;  Department of Anaesthesiology and Critical Care, Critical Care Unit, University Teaching Hospital of Purpan, Place du Dr Baylac, Toulouse Cedex 9, France, Critical Care and Anaesthesiology Department, University Teaching Hospital of Purpan, Place du Dr Baylac, Toulouse Cedex 9, France, Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Malagurski, Briguita;  Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Chauveau, Nicolas;  Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Bataille, Benoit;  Department of Anaesthesiology and Critical Care, Critical Care Unit, Hopital Dieu Hospital, Narbonne, France
Lotterie, Jean Albert;  Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Celsis, Pierre;  Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Aubry, Florent;  Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
Citerio, Giuseppe;  Department of Anaesthesiology and Critical Care, School of Medicine and Surgery, University Milano Bicocca and Hospital San Gerardo, Monza, Italy
Jean, Betty;  Department of Neuroradiology, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
Chabanne, Russel;  Department of Anaesthesiology and Critical Care, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
Perlbarg, Vincent;  Laboratoire d'Imagerie Biomédicale (UMR S 1146/UMR 7371), Université Pierre-et-Marie-Curie-Paris 06, Paris, France
Velly, Lionel;  Critical Care and Anaesthesiology Department, Groupe Hospitalier Pitié-Salpétrière, APHP, Paris, France
Galanaud, Damien;  Department of Neuroradiology, Groupe Hospitalier Pitié-Salpétrière, APHP, Paris, France
VANHAUDENHUYSE, Audrey  ;  Centre Hospitalier Universitaire de Liège - CHU > Service d'algologie - soins palliatifs
Fourcade, Olivier;  Critical Care and Anaesthesiology Department, University Teaching Hospital of Purpan, Place du Dr Baylac, Toulouse Cedex 9, France
Laureys, Steven  ;  Université de Liège - ULiège > GIGA : Coma Group
Puybasset, Louis;  Critical Care and Anaesthesiology Department, Groupe Hospitalier Pitié-Salpétrière, APHP, Paris, France
More authors (9 more) Less
Language :
English
Title :
Brain gray matter MRI morphometry for neuroprognostication after cardiac arrest
Publication date :
2017
Journal title :
Critical Care Medicine
ISSN :
0090-3493
eISSN :
1530-0293
Publisher :
Lippincott Williams and Wilkins
Volume :
45
Issue :
8
Pages :
e763-e771
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 06 January 2020

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