Early functional connectome integrity and 1-year recovery in comatose survivors of cardiac arrest

Haris I. Sair, Yousef Hannawi, Shanshan Li, Joshua Kornbluth, Athena Demertzi, Carol Di Perri, Russell Chabanne, Betty Jean, Habib Benali, Vincent Perlbarg, James Pekar, Charles Edouard Luyt, Damien Galanaud, Lionel Velly, Louis Puybasset, Steven Laureys, Brian Caffo, Robert D. Stevens

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)247-255
Number of pages9
JournalRADIOLOGY
Volume287
Issue number1
DOIs
StatePublished - Apr 2018

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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