Early Burst Suppression Similarity Association with Structural Brain Injury Severity on MRI After Cardiac Arrest
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Author(s)
Shivdat, Shawn
Zhan, Tiange
De Palma, Alessandro
Zheng, Wei-Long
Krishnamurthy, Parimala
Paneerselvam, Ezhil
Snider, Samuel
Bevers, Matthew
O’Reilly, Una-May
Lee, Jong W.
Date Issued
July 24, 2024
Journal
Neurocritical Care
Publisher
Springer US
Citation
Shivdat, S., Zhan, T., De Palma, A. et al. Early Burst Suppression Similarity Association with Structural Brain Injury Severity on MRI After Cardiac Arrest. Neurocrit Care 42, 175–184 (2025).
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Author's final manuscript
Abstract
Background Identical bursts on electroencephalography (EEG) are considered a specific predictor of poor outcomes in cardiac arrest, but its relationship with structural brain injury severity on magnetic resonance imaging (MRI) is not known. Methods This was a retrospective analysis of clinical, EEG, and MRI data from adult comatose patients after cardiac arrest. Burst similarity in first 72 h from the time of return of spontaneous circulation were calculated using dynamic time-warping (DTW) for bursts of equal (i.e., 500 ms) and varying (i.e., 100–500 ms) lengths and cross-correlation for bursts of equal lengths. Structural brain injury severity was measured using whole brain mean apparent diffusion coefficient (ADC) on MRI. Pearson’s correlation coefficients were calculated between mean burst similarity across consecutive 12–24-h time blocks and mean whole brain ADC values. Good outcome was defined as Cerebral Performance Category of 1–2 (i.e., independence for activities of daily living) at the time of hospital discharge. Results Of 113 patients with cardiac arrest, 45 patients had burst suppression (mean cardiac arrest to MRI time 4.3 days). Three study participants with burst suppression had a good outcome. Burst similarity calculated using DTW with bursts of varying lengths was correlated with mean ADC value in the first 36 h after cardiac arrest: Pearson’s r: 0–12 h: − 0.69 (p = 0.039), 12–24 h: − 0.54 (p = 0.002), 24–36 h: − 0.41 (p = 0.049). Burst similarity measured with bursts of equal lengths was not associated with mean ADC value with cross-correlation or DTW, except for DTW at 60–72 h (− 0.96, p = 0.04). Conclusions Burst similarity on EEG after cardiac arrest may be associated with acute brain injury severity on MRI. This association was time dependent when measured using DTW.
MIT Department
Massachusetts Institute of Technology. Computer Science and Artificial Intelligence Laboratory
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DOI of Published Version
https://doi.org/10.1007/s12028-024-02047-6
