EEG synchronization measures are early outcome predictors in comatose patients after cardiac arrest.

Zubler, Frédéric Alexis Rudolf; Steimer, Andreas; Kurmann, Rebekka; Bandarabadi, Mojtaba; Novy, Jan; Gast, Heidemarie; Oddo, Mauro; Schindler, Kaspar Anton; Rossetti, Andrea O (2017). EEG synchronization measures are early outcome predictors in comatose patients after cardiac arrest. Clinical neurophysiology, 128(4), pp. 635-642. Elsevier 10.1016/j.clinph.2017.01.020

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OBJECTIVE Outcome prognostication in comatose patients after cardiac arrest (CA) remains a major challenge. Here we investigated the prognostic value of combinations of linear and non-linear bivariate EEG synchronization measures. METHODS 94 comatose patients with EEG within 24h after CA were included. Clinical outcome was assessed at 3months using the Cerebral Performance Categories (CPC). EEG synchronization between the left and right parasagittal, and between the frontal and parietal brain regions was assessed with 4 different quantitative measures (delta power asymmetry, cross-correlation, mutual information, and transfer entropy). 2/3 of patients were used to assess the predictive power of all possible combinations of these eight features (4 measures×2 directions) using cross-validation. The predictive power of the best combination was tested on the remaining 1/3 of patients. RESULTS The best combination for prognostication consisted of 4 of the 8 features, and contained linear and non-linear measures. Predictive power for poor outcome (CPC 3-5), measured with the area under the ROC curve, was 0.84 during cross-validation, and 0.81 on the test set. At specificity of 1.0 the sensitivity was 0.54, and the accuracy 0.81. CONCLUSION Combinations of EEG synchronization measures can contribute to early prognostication after CA. In particular, combining linear and non-linear measures is important for good predictive power. SIGNIFICANCE Quantitative methods might increase the prognostic yield of currently used multi-modal approaches.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Zubler, Frédéric Alexis Rudolf; Steimer, Andreas; Kurmann, Rebekka; Bandarabadi, Mojtaba; Gast, Heidemarie and Schindler, Kaspar Anton

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1388-2457

Publisher:

Elsevier

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

27 Jul 2017 09:14

Last Modified:

27 Jul 2017 09:14

Publisher DOI:

10.1016/j.clinph.2017.01.020

PubMed ID:

28235724

Uncontrolled Keywords:

Anoxic-ischemic encephalopathy; Prognostication; Quantitative EEG; Synchronization

BORIS DOI:

10.7892/boris.99475

URI:

https://boris.unibe.ch/id/eprint/99475

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