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MRI Findings Prognostic for Long-Term Recovery in Cardiac Arrest

THURSDAY, Oct. 19, 2017 -- Measures of cerebral functional network connectivity measured within four weeks of cardiac arrest (CA) are associated with a favorable outcome (FO) at one year, according to a study published online Oct. 18 in Radiology.

Haris I. Sair, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues enrolled 46 patients who were comatose after CA. The authors assessed cerebral performance category at 12 months, with FO defined as category 1 or 2. Less than four weeks after CA (mean, 12.6 days), all participants underwent multiparametric structural and functional magnetic resonance imaging.

The researchers found that 11 patients had an FO at 12 months. Higher within-default-mode-network (DMN) connectivity was seen for patients with FO, and they also had greater anticorrelation between salience network (SN) and DMN and between SN and executive control network compared with patients with unfavorable outcome; this effect was maintained after adjustment for multiple variables. Compared with fluid-attenuated inversion recovery or diffusion-weighted imaging scores, anticorrelation of SN-DMN predicted outcomes with higher accuracy (area under the receiver operating characteristic curves, 0.88, 0.74, and 0.71, respectively).

"MR imaging-based measures of cerebral functional network connectivity obtained in the acute phase of CA were independently associated with FO at one year, warranting validation as early markers of long-term recovery potential in patients with anoxic-ischemic encephalopathy," the authors write.

Two authors disclosed ties to the biopharmaceutical and health care industries; one author disclosed having a patent issued for an ex vivo method for quantifying brain injuries.

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Posted: October 2017