Prognostic Value of A Qualitative Brain MRI Scoring System After Cardiac Arrest

Hirsch, Karen G.; Mlynash, Michael; Jansen, Sanne; Persoon, Suzanne; Eyngorn, Irina; Krasnokutsky, Michael V.; Wijman, Christine A.C.; Fischbein, Nancy J.

doi:10.1111/jon.12143

Cited by 68 publications

(74 citation statements)

References 21 publications

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“…Previous studies have shown that injury to specific brain regions, such as the cortical gray matter and deep gray structures, correlated with poor patient outcomes [27,28]. In this study, specific regions of interest were not analyzed independently of the whole brain quantitative analysis though future work will incorporate this analysis.…”

Section: Discussionmentioning

confidence: 97%

Multi-Center Study of Diffusion-Weighted Imaging in Coma After Cardiac Arrest

et al. 2015

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Section: Discussionmentioning

confidence: 97%

Multi-Center Study of Diffusion-Weighted Imaging in Coma After Cardiac Arrest

et al. 2015

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“…MR imaging morphologic analysis was accomplished by using two validated scores on the basis of a visual rating (23,24). In the system proposed by Hirsch et al (24), developed in a similar population with CA, the anatomic location and degree of signal abnormality measure extensively validated in patients with CA that describes five levels of functional ability: 1, good cerebral performance (ie, alert, able to work); 2, moderate disability (ie, conscious, independent in most activities of daily living); 3, severe disability (ie, conscious but dependent in most activities of daily living); 4, coma or vegetative state; and 5, brain death. Patients with a cerebral performance category score of 1-2 were classified as having a favorable outcome (FO) and those with a cerebral performance category score of 3-5 were classified as having an unfavorable outcome.…”

Section: Image Processingmentioning

confidence: 99%

Early Functional Connectome Integrity and 1-Year Recovery in Comatose Survivors of Cardiac Arrest

Sair¹,

Hannawi²,

Li³

et al. 2018

Radiology

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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 between-network 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 fluid-attenuated 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 SN-DMN 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. RSNA, 2017.

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“…Anoxia-induced brain swelling in the acute phase after CA is associated with diffuse brain damage in thalamus, basal ganglia, cerebellum, hippocampus, frontal, and parietal cortices [24][25][26]. Neural degeneration over time in these regions has been described in nonsurvivors of CA [27,28]. Because neural processing in hippocampal [29][30][31] and frontoparietal regions [32,33] plays a crucial role for sensory-memory trace formation and violation detection, the progression of auditory discrimination measured in our study might directly reflect the progression of anoxia-induced functional impairment in these brain regions.…”

Section: Brain Mechanisms Of Auditory Discrimination Progressionmentioning

confidence: 99%