Verhulst Marlous M L H, Lange Puck, Tuladhar Anil Man, Tewarie Prejaas, van Gils Pauline C W, van Heugten Caroline, Bonnes Judith, Delnoij Thijs, Helmich Rick, Hofmeijer Jeannette
Clinical Neurophysiology, TechMed Centre, University of Twente, Enschede, the Netherlands.
Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands.
Neuroimage Rep. 2025 Feb 13;5(1):100244. doi: 10.1016/j.ynirp.2025.100244. eCollection 2025 Mar.
Half of all cardiac arrest patients experience long-term cognitive impairment. Identifying patients at risk is challenging and underlying mechanisms are incompletely understood. Since postanoxic encephalopathy is diffuse, measures of global network organization might contribute to identifying these patients at risk. We studied MRI-based whole-brain and subnetwork topology in relation to short- and long-term cognitive outcomes after cardiac arrest.
We performed a multicenter prospective cohort study in cardiac arrest survivors. Patients underwent resting-state functional MRI during hospitalization (within one month after cardiac arrest). We analyzed 264 regions of interest using Power's atlas, extracting mean timeseries and calculating pairwise connectivity with Pearson's correlation. Overall functional connectivity, global efficiency, clustering coefficient, and modularity were calculated for the whole brain and five subnetworks. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) during hospitalization, at three, and twelve months, and using neuropsychological examination at twelve months. Mixed effects models were used to examine relationships between topology measures and cognitive outcomes. We corrected for multiple testing.
We included 80 patients (age 60 ± 11 years, 70 (90%) male). Our analyses showed consistent relations between various topology measures of the sensory/somatomotor network (SSN) and MoCA score during hospitalization and memory, attention, and executive functioning at twelve months follow up. After correction for multiple testing, we found no statistically significant relations between whole-brain and subnetwork graph measures and cognitive outcomes.
Early whole brain functional topology was not related to short- or long-term cognitive outcome after cardiac arrest in this analysis. Potential relations between SSN topology and cognitive outcome point towards spatial heterogeneity of postanoxic encephalopathy. Possible predictive values of SSN structure or function need further investigation.
所有心脏骤停患者中有一半会经历长期认知障碍。识别有风险的患者具有挑战性，其潜在机制尚未完全了解。由于缺氧后脑病是弥漫性的，全球网络组织的测量方法可能有助于识别这些有风险的患者。我们研究了基于磁共振成像（MRI）的全脑和子网拓扑结构与心脏骤停后短期和长期认知结果的关系。
我们对心脏骤停幸存者进行了一项多中心前瞻性队列研究。患者在住院期间（心脏骤停后1个月内）接受静息态功能MRI检查。我们使用Power图谱分析了264个感兴趣区域，提取平均时间序列并使用Pearson相关性计算成对连通性。计算了全脑和五个子网的整体功能连通性、全局效率、聚类系数和模块性。在住院期间、3个月和12个月时使用蒙特利尔认知评估（MoCA）测量认知功能，并在12个月时使用神经心理学检查。使用混合效应模型检查拓扑测量与认知结果之间的关系。我们对多重检验进行了校正。
我们纳入了80名患者（年龄60±11岁，70名（90%）男性）。我们的分析表明，感觉/躯体运动网络（SSN）的各种拓扑测量与住院期间的MoCA评分以及12个月随访时的记忆、注意力和执行功能之间存在一致的关系。在对多重检验进行校正后，我们发现全脑和子网图测量与认知结果之间没有统计学上的显著关系。
在此分析中，早期全脑功能拓扑与心脏骤停后的短期或长期认知结果无关。SSN拓扑与认知结果之间的潜在关系指向缺氧后脑病的空间异质性。SSN结构或功能的可能预测价值需要进一步研究。
