Topography of MR lesions correlates with standardized EEG pattern in early comatose survivors after cardiac arrest.

Barth, Rike; Zubler, Frederic; Weck, Anja; Haenggi, Matthias; Schindler, Kaspar; Wiest, Roland; Wagner, Franca (2020). Topography of MR lesions correlates with standardized EEG pattern in early comatose survivors after cardiac arrest. Resuscitation, 149, pp. 217-224. Elsevier 10.1016/j.resuscitation.2020.01.014

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AIM Multimodal prognostication in comatose patients after cardiac arrest (CA) is complicated by the fact that different modalities are usually not independent. Here we set out to systematically correlate early EEG and MRI findings. METHODS 89 adult patients from a prospective register who underwent at least one EEG and one MRI in the acute phase after CA were included. The EEGs were characterized using pre-existent standardized categories (highly malignant, malignant, benign). For MRIs, the apparent diffusion coefficient (ADC) was computed in pre-defined regions. We then introduced a novel classification based on the topography of ADC reduction (MR-lesion pattern (MLP) 1: no lesion; MLP 2: purely cortical lesions; MLP 3: involvement of the basal ganglia; MLP 4 involvement of other deep grey matter regions). RESULTS EEG background reactivity and EEG background continuity were strongly associated with a higher MLP value (p < 0.001 and p = 0.003 respectively). The EEG categories highly malignant, malignant and benign were strongly correlated with the MLP values (rho = 0.46, p < 0.001). CONCLUSION The MRI lesions are highly correlated with the EEG pattern. Our results suggest that performing MRI in comatose patients after CA with either highly malignant or with a benign EEG pattern is unlikely to yield additional useful information for prognostication, and should therefore be performed in priority in patients with intermediate EEG patterns ("malignant pattern").

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Barth, Rike; Zubler, Frédéric; Weck, Anja; Hänggi, Matthias; Schindler, Kaspar Anton; Wiest, Roland and Wagner, Franca

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1873-1570

Publisher:

Elsevier

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

07 Feb 2020 13:43

Last Modified:

03 Apr 2020 01:33

Publisher DOI:

10.1016/j.resuscitation.2020.01.014

PubMed ID:

31982504

Uncontrolled Keywords:

EEG MRI cardiac arrest coma hypoxic ischemic encephalopathy prognostication

BORIS DOI:

10.7892/boris.139680

URI:

https://boris.unibe.ch/id/eprint/139680

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