ArticleAnnals of neurology2020
Independent Functional Outcomes after Prolonged Coma following Cardiac Arrest: A Mechanistic Hypothesis.
Article in Annals of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed, 38 citations in OpenAlex.
- Recovery of consciousness after acute brain injury: a narrative review.Journal of intensive care · 2024Review
- Review
- Neuromonitoring after Pediatric Cardiac Arrest: Cerebral Physiology and Injury Stratification.Neurocritical care · 2024Review
- Distinct Spectral Profiles of Awake Resting EEG in Disorders of Consciousness: The Role of Frequency and Topography of Oscillations.Brain topography · 2024Article
- Common Data Elements for Disorders of Consciousness: Recommendations from the Electrophysiology Working Group.Neurocritical care · 2023Article
- Neurophysiology State Dynamics Underlying Acute Neurologic Recovery After Cardiac Arrest.Neurology · 2023Article
- Protective down-regulated states in the human brain: A possible lesson from COVID-19.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- Prolonged Unconsciousness is Common in COVID-19 and Associated with Hypoxemia.Annals of neurology · 2022Article
- Regional Distribution of Brain Injury After Cardiac Arrest: Clinical and Electrographic Correlates.Neurology · 2022Article
- Mitigation of perioperative neurocognitive disorders: A holistic approach.Frontiers in aging neuroscience · 2022Review
- Non-invasive Vagus Nerve Stimulation in Treatment of Disorders of Consciousness - Longitudinal Case Study.Frontiers in neuroscience · 2022Article
- Brain Activity Characteristics of Patients With Disorders of Consciousness in the EEG Resting State Paradigm: A Review.Frontiers in systems neuroscience · 2022Review
- Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness.Neurocritical care · 2021Article
- Etiology of Burst Suppression EEG Patterns.Frontiers in psychology · 2021Article
- Critical care EEG standardized nomenclature in clinical practice: Strengths, limitations, and outlook on the example of prognostication after cardiac arrest.Clinical neurophysiology practice · 2021Review
- Burst Suppression During General Anesthesia and Postoperative Outcomes: Mini Review.Frontiers in systems neuroscience · 2021Review
- Delayed reemergence of consciousness in survivors of severe COVID-19.Neurocritical care · 2020Article
- Novel approaches to prediction in severe brain injury.Current opinion in neurology · 2020Review
- The Curing Coma Campaign: Framing Initial Scientific Challenges-Proceedings of the First Curing Coma Campaign Scientific Advisory Council Meeting.Neurocritical care · 2020Article
- Mechanistic Wager on Outcome in Coma After Cardiac Arrest: The EEG Signature in Burst Suppression Provides Some Clues.Epilepsy currentsArticle
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3 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveSurvivors of prolonged (>2 weeks) post-cardiac arrest (CA) coma are expected to remain permanently disabled. We aimed to investigate 3 outlier patients who ultimately achieved independent functional outcomes after prolonged post-CA coma to identify electroencephalographic (EEG) markers of their recovery potential. For validation purposes, we also aimed to evaluate these markers in an independent cohort of post-CA patients.
methodsWe identified 3 patients with late recovery from coma (17-37 days) following CA who recovered to functionally independent behavioral levels. We performed spectral power analyses of available EEGs during prominent burst suppression patterns (BSP) present in all 3 patients. Using identical methods, we also assessed the relationship of intraburst spectral power and outcomes in a prospectively enrolled cohort of post-CA patients. We performed chart reviews of common clinical, imaging, and EEG prognostic variables and clinical outcomes for all patients.
resultsAll 3 patients with late recovery from coma lacked evidence of overwhelming cortical injury but demonstrated prominent BSP on EEG. Spectral analyses revealed a prominent theta (~4-7Hz) feature dominating the bursts during BSP in these patients. In the prospective cohort, similar intraburst theta spectral features were evident in patients with favorable outcomes; patients with BSP and unfavorable outcomes showed either no features, transient burst features, or decreasing intraburst frequencies with time.
interpretationBSP with theta (~4-7Hz) peak intraburst spectral power after CA may index a recovery potential. We discuss our results in the context of optimizing metabolic substrate availability and stimulating the corticothalamic system during recovery from prolonged post-CA coma. ANN NEUROL 2020;87:618-632.
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