[en] Purpose: To assess whether early brain functional connectivity is associated with functional recovery 1 year after cardiac arrest (CA). Materials and Methods: Enrolled in this prospective multicenter cohort were 46 patients who were comatose after CA. Principal outcome was cerebral performance category at 12 months, with favorable outcome (FO) defined as cerebral performance category 1 or 2. All participants underwent multiparametric structural and functional magnetic resonance (MR) imaging less than 4 weeks after CA. Within-and betweennetwork connectivity was measured in dorsal attention network (DAN), default-mode network (DMN), salience network (SN), and executive control network (ECN) by using seed-based analysis of resting-state functional MR imaging data. Structural changes identified with fluidattenuated inversion recovery and diffusion-weighted imaging sequences were analyzed by using validated morphologic scales. The association between connectivity measures, structural changes, and the principal outcome was explored with multivariable modeling. Results: Patients underwent MR imaging a mean 12.6 days ± 5.6 (standard deviation) after CA. At 12 months, 11 patients had an FO. Patients with FO had higher within-DMN connectivity and greater anticorrelation between SN and DMN and between SN and ECN compared with patients with unfavorable outcome, an effect that was maintained after multivariable adjustment. Anticorrelation of SNDMN predicted outcomes with higher accuracy than fluid-Attenuated inversion recovery or diffusion-weighted imaging scores (area under the receiver operating characteristic curves, respectively, 0.88, 0.74, and 0.71). Conclusion: MR imaging-based measures of cerebral functional network connectivity obtained in the acute phase of CA were independently associated with FO at 1 year, warranting validation as early markers of long-Term recovery potential in patients with anoxic-ischemic encephalopathy.
Disciplines :
Neurology
Author, co-author :
Sair, Haris Iqbal; Departments of Radiology and Radiological Science, 600 N Wolfe St, Phipps 455, Baltimore, MD, United States
Hannawi, Yousef; Departments of Anesthesiology and Critical Care Medicine, 600 N Wolfe St, Phipps 455, Baltimore, MD, United States, Departments of Neurology, 600 N Wolfe St, Phipps 455, Baltimore, MD, United States, Department of Neurology, Ohio State University, Columbus, OH, United States
Li, Shanshan; Department of Biostatistics, Indiana University Fairbanks School of Public Health, Indianapolis, IN, United States
Kornbluth, Joshua; Department of Neurology, Tufts University School of Medicine, Boston, MA, United States
Demertzi, Athina ; Université de Liège - ULiège > Centre de recherches du cyclotron
Di Perri, Carol ; Université de Liège - ULiège > GIGA : Coma Group
Chabanne, Russell; Departments of Anesthesia Resuscitation, Clermont-Ferrand, France
Jean, Beatrix; Departments of Neuroradiology, Centre Hospitalier Universitaire, Clermont-Ferrand, France
Benali, Habib; Functional Imaging Laboratory U678, Faculté de Médecine Pierre et Marie Curie, Paris, France
Perlbarg, Vincent; Functional Imaging Laboratory U678, Faculté de Médecine Pierre et Marie Curie, Paris, France
Pekar, James; F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
Luyt, Charles-Édouard; Medical Resuscitation Service, United States
Galanaud, Damien; Department of Neuroradiology, Paris, France
Velly, Lionel ; Department of Neurosurgical Resuscitation Service, Groupe Hospitalier Pitié-Salpêtrière Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France
Puybasset, Louis; Department of Neurosurgical Resuscitation Service, Groupe Hospitalier Pitié-Salpêtrière Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France
Laureys, Steven ; Université de Liège - ULiège > GIGA : Coma Group
Caffo, Brian; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
Stevens, Robert David; Departments of Radiology and Radiological Science, 600 N Wolfe St, Phipps 455, Baltimore, MD, United States, Departments of Anesthesiology and Critical Care Medicine, 600 N Wolfe St, Phipps 455, Baltimore, MD, United States, Departments of Neurology, 600 N Wolfe St, Phipps 455, Baltimore, MD, United States, Departments of Neurosurgery, Johns Hopkins University School of Medicine, 600 N Wolfe St, Phipps 455, Baltimore, MD, United States
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