Shivdat Shawn, Zhan Tiange, De Palma Alessandro, Zheng Wei-Long, Krishnamurthy Parimala, Paneerselvam Ezhil, Snider Samuel, Bevers Matthew, O'Reilly Una-May, Lee Jong Woo, Westover M Brandon, Amorim Edilberto
Harvard College, Cambridge, MA, USA.
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Neurocrit Care. 2025 Feb;42(1):175-184. doi: 10.1007/s12028-024-02047-6. Epub 2024 Jul 24.
Identical bursts on electroencephalography (EEG) are considered a specific predictor of poor outcomes in cardiac arrest, but its relationship with structural brain injury severity on magnetic resonance imaging (MRI) is not known.
This was a retrospective analysis of clinical, EEG, and MRI data from adult comatose patients after cardiac arrest. Burst similarity in first 72 h from the time of return of spontaneous circulation were calculated using dynamic time-warping (DTW) for bursts of equal (i.e., 500 ms) and varying (i.e., 100-500 ms) lengths and cross-correlation for bursts of equal lengths. Structural brain injury severity was measured using whole brain mean apparent diffusion coefficient (ADC) on MRI. Pearson's correlation coefficients were calculated between mean burst similarity across consecutive 12-24-h time blocks and mean whole brain ADC values. Good outcome was defined as Cerebral Performance Category of 1-2 (i.e., independence for activities of daily living) at the time of hospital discharge.
Of 113 patients with cardiac arrest, 45 patients had burst suppression (mean cardiac arrest to MRI time 4.3 days). Three study participants with burst suppression had a good outcome. Burst similarity calculated using DTW with bursts of varying lengths was correlated with mean ADC value in the first 36 h after cardiac arrest: Pearson's r: 0-12 h: - 0.69 (p = 0.039), 12-24 h: - 0.54 (p = 0.002), 24-36 h: - 0.41 (p = 0.049). Burst similarity measured with bursts of equal lengths was not associated with mean ADC value with cross-correlation or DTW, except for DTW at 60-72 h (- 0.96, p = 0.04).
Burst similarity on EEG after cardiac arrest may be associated with acute brain injury severity on MRI. This association was time dependent when measured using DTW.
脑电图（EEG）上的相同波群被认为是心脏骤停后预后不良的一种特异性预测指标，但其与磁共振成像（MRI）上脑结构损伤严重程度的关系尚不清楚。
这是一项对心脏骤停后成年昏迷患者的临床、EEG和MRI数据进行的回顾性分析。从自主循环恢复之时起的最初72小时内，使用动态时间规整（DTW）计算等长（即500毫秒）和不等长（即100 - 500毫秒）波群的波群相似性，对等长波群使用互相关分析。使用MRI上的全脑平均表观扩散系数（ADC）测量脑结构损伤严重程度。计算连续12 - 24小时时间段内的平均波群相似性与全脑平均ADC值之间的Pearson相关系数。良好预后定义为出院时脑功能分级为1 - 2级（即日常生活活动自理）。
在113例心脏骤停患者中，45例出现波群抑制（心脏骤停至MRI检查的平均时间为4.3天）。3例有波群抑制的研究参与者预后良好。使用DTW计算的不等长波群的波群相似性与心脏骤停后最初36小时内的平均ADC值相关：Pearson相关系数r：0 - 12小时： - 0.69（p = 0.039），12 - 24小时： - 0.54（p = 0.002），24 - 36小时： - 0.41（p = 0.049）。除了60 - 72小时使用DTW测量时（ - 0.96，p = 0.04），等长波群测量的波群相似性与互相关分析或DTW测量的平均ADC值均无关联。
心脏骤停后EEG上的波群相似性可能与MRI上的急性脑损伤严重程度相关。使用DTW测量时，这种关联具有时间依赖性。
