Dynamic functional connectivity of the EEG in relation to outcome of postanoxic coma

H.M. Keijzer*, M.C. Tjepkema-Cloostermans, C.J.M. Klijn, M. Blans, M.J.A.M. van Putten, J. Hofmeijer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
163 Downloads (Pure)

Abstract

Objective: Early EEG contains reliable information for outcome prediction of comatose patients after cardiac arrest. We introduce dynamic functional connectivity measures and estimate additional predictive values.

Methods: We performed a prospective multicenter cohort study on continuous EEG for outcome prediction of comatose patients after cardiac arrest. We calculated Link Rates (LR) and Link Durations (LD) in the α, δ, and θ band, based on similarity of instantaneous frequencies in five-minute EEG epochs, hourly, during 3 days after cardiac arrest. We studied associations of LR and LD with good (Cerebral Performance Category (CPC) 1–2) or poor outcome (CPC 3–5) with univariate analyses. With random forest classification, we established EEG-based predictive models. We used receiver operating characteristics to estimate additional values of dynamic connectivity measures for outcome prediction.

Results: Of 683 patients, 369 (54%) had poor outcome. Patients with poor outcome had significantly lower LR and longer LD, with largest differences 12 h after cardiac arrest (LRθ 1.87 vs. 1.95 Hz and LDα 91 vs. 82 ms). Adding these measures to a model with classical EEG features increased sensitivity for reliable prediction of poor outcome from 34% to 38% at 12 h after cardiac arrest.

Conclusion: Poor outcome is associated with lower dynamics of connectivity after cardiac arrest. Significance: Dynamic functional connectivity analysis may improve EEG based outcome prediction.

Original languageEnglish
Pages (from-to)157-164
Number of pages8
JournalClinical neurophysiology
Volume132
Issue number1
DOIs
Publication statusPublished - Jan 2021

Keywords

  • Dynamic functional connectivity
  • EEG
  • Outcome
  • Postanoxic coma

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