Early Functional Connectome Integrity and 1-Year Recovery in Comatose Survivors of Cardiac Arrest

Abstract

When conducted in the acute phase after cardiac arrest, preservation of resting-state functional connectivity within the default mode network and between the default mode and salience networks is linked with a higher likelihood of 1-year functional recovery; the biological significance of these results and their validity in the clinical setting merit further investigation. Purpose To assess whether early brain functional connectivity is associated with functional recovery 1 year after cardiac arrest (CA). Materials and Methods Enrolled in this prospective multicenter cohort were 46 patients who were comatose after CA. Principal outcome was cerebral performance category at 12 months, with favorable outcome (FO) defined as cerebral performance category 1 or 2. All participants underwent multiparametric structural and functional magnetic resonance (MR) imaging less than 4 weeks after CA. Within- and between-network connectivity was measured in dorsal attention network (DAN), default-mode network (DMN), salience network (SN), and executive control network (ECN) by using seed-based analysis of resting-state functional MR imaging data. Structural changes identified with fluid-attenuated inversion recovery and diffusion-weighted imaging sequences were analyzed by using validated morphologic scales. The association between connectivity measures, structural changes, and the principa...