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Abstract：
BACKGROUND: This study aimed to explore the characteristics of abnormal regional resting-state functional magnetic resonance imaging (rs-fMRI) activity in comatose patients in the early period after cardiac arrest (CA), and to investigate their relationships with neurological outcomes. We also explored the correlations between jugular venous oxygen saturation (SjvO2) and rs-fMRI activity in resuscitated comatose patients. We also examined the relationship between the amplitude of the N20-baseline and the rs-fMRI activity within the intracranial conduction pathway of somatosensory evoked potentials (SSEPs).
METHODS: Between January 2021 and January 2024, eligible post-resuscitated patients were screened to undergo fMRI examination. The amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of rs-fMRI blood oxygenation level-dependent (BOLD) signals were used to characterize regional neural activity. Neurological outcomes were evaluated using the Glasgow-Pittsburgh cerebral performance category (CPC) scale at 3 months after CA.
RESULTS: In total, 20 healthy controls and 31 post-resuscitated patients were enrolled in this study. The rs-fMRI activity of resuscitated patients revealed complex changes, characterized by increased activity in some local brain regions and reduced activity in others compared to healthy controls (P < 0.05). However, the mean ALFF values of the whole brain were significantly greater in CA patients (P = 0.011). Among the clusters of abnormal rs-fMRI activity, the cluster values of ALFF in the left middle temporal gyrus and inferior temporal gyrus and the cluster values of ReHo in the right precentral gyrus, superior frontal gyrus and middle frontal gyrus were strongly correlated with the CPC score (P < 0.001). There was a strong correlation between the mean ALFF and SjvO2 in CA patients (r = 0.910, P < 0.001). The SSEP N20-baseline amplitudes in CA patients were negatively correlated with thalamic rs-fMRI activity (all P < 0.001).
CONCLUSIONS: This study revealed that abnormal rs-fMRI BOLD signals in resuscitated patients showed complex changes, characterized by increased activity in some local brain regions and reduced activity in others. Abnormal BOLD signals were associated with neurological outcomes in resuscitated patients. The mean ALFF values of the whole brain were closely related to SjvO2 levels, and changes in the thalamic BOLD signals correlated with the N20-baseline amplitudes of SSEP responses.
BACKGROUND: NCT05966389 (Registered July 27, 2023).
METHODS: Between January 2021 and January 2024, eligible post-resuscitated patients were screened to undergo fMRI examination. The amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of rs-fMRI blood oxygenation level-dependent (BOLD) signals were used to characterize regional neural activity. Neurological outcomes were evaluated using the Glasgow-Pittsburgh cerebral performance category (CPC) scale at 3 months after CA.
RESULTS: In total, 20 healthy controls and 31 post-resuscitated patients were enrolled in this study. The rs-fMRI activity of resuscitated patients revealed complex changes, characterized by increased activity in some local brain regions and reduced activity in others compared to healthy controls (P < 0.05). However, the mean ALFF values of the whole brain were significantly greater in CA patients (P = 0.011). Among the clusters of abnormal rs-fMRI activity, the cluster values of ALFF in the left middle temporal gyrus and inferior temporal gyrus and the cluster values of ReHo in the right precentral gyrus, superior frontal gyrus and middle frontal gyrus were strongly correlated with the CPC score (P < 0.001). There was a strong correlation between the mean ALFF and SjvO2 in CA patients (r = 0.910, P < 0.001). The SSEP N20-baseline amplitudes in CA patients were negatively correlated with thalamic rs-fMRI activity (all P < 0.001).
CONCLUSIONS: This study revealed that abnormal rs-fMRI BOLD signals in resuscitated patients showed complex changes, characterized by increased activity in some local brain regions and reduced activity in others. Abnormal BOLD signals were associated with neurological outcomes in resuscitated patients. The mean ALFF values of the whole brain were closely related to SjvO2 levels, and changes in the thalamic BOLD signals correlated with the N20-baseline amplitudes of SSEP responses.
BACKGROUND: NCT05966389 (Registered July 27, 2023).
摘要：
背景：本研究旨在探讨心脏骤停（CA）后早期昏迷患者局部静息态功能磁共振成像（rs-fMRI）活动异常的特征，并调查它们与神经系统预后的关系。我们还探讨了复苏后昏迷患者颈静脉血氧饱和度（SjvO2）与rs-fMRI活动之间的相关性。我们还检查了N20基线幅度与体感诱发电位（SSEP）颅内传导途径内rs-fMRI活动之间的关系。
方法：在2021年1月至2024年1月之间，筛选符合条件的复苏后患者进行功能磁共振成像检查。低频波动幅度(ALFF),分数ALFF(fALFF)，rs-fMRI血氧水平依赖性（BOLD）信号的区域同质性（ReHo）用于表征区域神经活动。在CA后3个月使用格拉斯哥-匹兹堡脑表现类别（CPC）量表评估神经系统结局。
结果：总计，20名健康对照和31名复苏后患者被纳入这项研究。复苏患者的rs-fMRI活动显示出复杂的变化，与健康对照组相比，某些局部大脑区域的活动增加，而其他区域的活动减少（P<0.05）。然而,CA患者全脑的平均ALFF值显著增高(P=0.011).在异常rs-fMRI活动的集群中，左颞中回和颞下回的ALFF聚类值和右中央前回的ReHo聚类值，额上回和中额回与CPC评分密切相关(P<0.001)。CA患者的平均ALFF与SjvO2之间存在很强的相关性（r=0.910，P<0.001）。CA患者的SSEPN20基线振幅与丘脑rs-fMRI活性呈负相关（均P<0.001）。
结论：这项研究表明，复苏患者的rs-fMRIBOLD信号异常表现出复杂的变化，以某些局部大脑区域的活动增加而另一些区域的活动减少为特征。复苏患者的BOLD信号异常与神经系统预后相关。整个大脑的平均ALFF值与SjvO2水平密切相关，丘脑BOLD信号的变化与SSEP反应的N20基线幅度相关。
背景：NCT05966389（注册于2023年7月27日）。
方法：在2021年1月至2024年1月之间，筛选符合条件的复苏后患者进行功能磁共振成像检查。低频波动幅度(ALFF),分数ALFF(fALFF)，rs-fMRI血氧水平依赖性（BOLD）信号的区域同质性（ReHo）用于表征区域神经活动。在CA后3个月使用格拉斯哥-匹兹堡脑表现类别（CPC）量表评估神经系统结局。
结果：总计，20名健康对照和31名复苏后患者被纳入这项研究。复苏患者的rs-fMRI活动显示出复杂的变化，与健康对照组相比，某些局部大脑区域的活动增加，而其他区域的活动减少（P<0.05）。然而,CA患者全脑的平均ALFF值显著增高(P=0.011).在异常rs-fMRI活动的集群中，左颞中回和颞下回的ALFF聚类值和右中央前回的ReHo聚类值，额上回和中额回与CPC评分密切相关(P<0.001)。CA患者的平均ALFF与SjvO2之间存在很强的相关性（r=0.910，P<0.001）。CA患者的SSEPN20基线振幅与丘脑rs-fMRI活性呈负相关（均P<0.001）。
结论：这项研究表明，复苏患者的rs-fMRIBOLD信号异常表现出复杂的变化，以某些局部大脑区域的活动增加而另一些区域的活动减少为特征。复苏患者的BOLD信号异常与神经系统预后相关。整个大脑的平均ALFF值与SjvO2水平密切相关，丘脑BOLD信号的变化与SSEP反应的N20基线幅度相关。
背景：NCT05966389（注册于2023年7月27日）。
