Kim Tae Jung, Kim Jae-Myoung, Lee Ji Sung, Park Soo-Hyun, Cha Jihyun, Bae Hyeon-Min, Ko Sang-Bae
Department of Neurology, Seoul National University, College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Sci Rep. 2025 May 23;15(1):18040. doi: 10.1038/s41598-025-02658-9.
We investigated the relationship between prefrontal functional connectivity of oxyhemoglobin and outcomes in sepsis-associated encephalopathy (SAE). Additionally, we developed a prognostic method for patients with SAE. A total of 40 consecutive patients with SAE were prospectively included. Cerebral oxyhemoglobin data were obtained using functional near-infrared spectroscopy. Functional connectivity such as density was evaluated as the strength of the temporal correlation between channels based on Pearson's correlation coefficient of oxyhemoglobin. We obtained clinical information and evaluated severity scores using Acute Physiology and Chronic Health Evaluation (APACHE) III. Outcomes were evaluated using the modified Rankin Scale (mRS) at discharge. Patients were categorized into two groups: good outcome (mRS 0-3), and poor outcome (mRS 4-6). Among the patients with SAE, 17 (42.5%) had good outcomes. Regarding connectivity analysis, density values were significantly higher in good outcome groups at all threshold values. The developed predictive method of good outcomes using the density value at a threshold of 0.6 and the APACHE III score showed very good predictive power (area under the curve 0.951 [95% confidence interval 0.893-1.00]). This method had better discrimination powers for predicting outcome than density had at 0.6 (0.716 [0.557-0.876]; P = 0.04) or the APACHE III score had alone (0.857 [0.735-0.979]; P = 0.09). A higher functional connectivity value of oxyhemoglobin in the prefrontal connectivity analysis was associated with good outcomes in SAE. Functional connectivity analysis of the prefrontal cortex and sepsis severity may help predict the prognosis in SAE patients.
我们研究了氧合血红蛋白的前额叶功能连接性与脓毒症相关性脑病（SAE）预后之间的关系。此外，我们还开发了一种针对SAE患者的预后评估方法。前瞻性纳入了40例连续的SAE患者。使用功能近红外光谱法获取脑氧合血红蛋白数据。基于氧合血红蛋白的Pearson相关系数，将诸如密度等功能连接性评估为通道间时间相关性的强度。我们获取了临床信息，并使用急性生理与慢性健康评估（APACHE）III来评估严重程度评分。出院时使用改良Rankin量表（mRS）评估预后。患者被分为两组：良好预后（mRS 0 - 3）和不良预后（mRS 4 - 6）。在SAE患者中，17例（42.5%）预后良好。关于连接性分析，在所有阈值下，良好预后组的密度值均显著更高。使用阈值为0.6时的密度值和APACHE III评分开发的良好预后预测方法显示出非常好的预测能力（曲线下面积为0.951 [95%置信区间0.893 - 1.00]）。该方法在预测预后方面的辨别能力优于阈值为0.6时的密度（0.716 [0.557 - 0.876]；P = 0.04）或单独的APACHE III评分（0.857 [0.735 - 0.979]；P = 0.09）。前额叶连接性分析中氧合血红蛋白的功能连接性值较高与SAE的良好预后相关。前额叶皮质的功能连接性分析和脓毒症严重程度可能有助于预测SAE患者的预后。
