Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI data

Introduction: Half of all cardiac arrest patients experience long-term cognitive impairment. Identifying patients at risk is challenging and underlying mechanisms are incompletely understood. Since postanoxic encephalopathy is diffuse, measures of global network organization might contribute to iden...

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Main Authors: Marlous M.L.H. Verhulst, Puck Lange, Anil Man Tuladhar, Prejaas Tewarie, Pauline C.W. van Gils, Caroline van Heugten, Judith Bonnes, Thijs Delnoij, Rick Helmich, Jeannette Hofmeijer
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Language:English
Published: Elsevier 2025-03-01
Series:NeuroImage: Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666956025000121
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author Marlous M.L.H. Verhulst
Puck Lange
Anil Man Tuladhar
Prejaas Tewarie
Pauline C.W. van Gils
Caroline van Heugten
Judith Bonnes
Thijs Delnoij
Rick Helmich
Jeannette Hofmeijer
author_facet Marlous M.L.H. Verhulst
Puck Lange
Anil Man Tuladhar
Prejaas Tewarie
Pauline C.W. van Gils
Caroline van Heugten
Judith Bonnes
Thijs Delnoij
Rick Helmich
Jeannette Hofmeijer
author_sort Marlous M.L.H. Verhulst
collection DOAJ
description Introduction: Half of all cardiac arrest patients experience long-term cognitive impairment. Identifying patients at risk is challenging and underlying mechanisms are incompletely understood. Since postanoxic encephalopathy is diffuse, measures of global network organization might contribute to identifying these patients at risk. We studied MRI-based whole-brain and subnetwork topology in relation to short- and long-term cognitive outcomes after cardiac arrest. Methods: We performed a multicenter prospective cohort study in cardiac arrest survivors. Patients underwent resting-state functional MRI during hospitalization (within one month after cardiac arrest). We analyzed 264 regions of interest using Power's atlas, extracting mean timeseries and calculating pairwise connectivity with Pearson's correlation. Overall functional connectivity, global efficiency, clustering coefficient, and modularity were calculated for the whole brain and five subnetworks. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) during hospitalization, at three, and twelve months, and using neuropsychological examination at twelve months. Mixed effects models were used to examine relationships between topology measures and cognitive outcomes. We corrected for multiple testing. Results: We included 80 patients (age 60 ± 11 years, 70 (90%) male). Our analyses showed consistent relations between various topology measures of the sensory/somatomotor network (SSN) and MoCA score during hospitalization and memory, attention, and executive functioning at twelve months follow up. After correction for multiple testing, we found no statistically significant relations between whole-brain and subnetwork graph measures and cognitive outcomes. Conclusion: Early whole brain functional topology was not related to short- or long-term cognitive outcome after cardiac arrest in this analysis. Potential relations between SSN topology and cognitive outcome point towards spatial heterogeneity of postanoxic encephalopathy. Possible predictive values of SSN structure or function need further investigation.
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spelling doaj-art-24478355fca345479e7bcad4cb7a6aa92025-08-20T03:01:42ZengElsevierNeuroImage: Reports2666-95602025-03-015110024410.1016/j.ynirp.2025.100244Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI dataMarlous M.L.H. Verhulst0Puck Lange1Anil Man Tuladhar2Prejaas Tewarie3Pauline C.W. van Gils4Caroline van Heugten5Judith Bonnes6Thijs Delnoij7Rick Helmich8Jeannette Hofmeijer9Clinical Neurophysiology, TechMed Centre, University of Twente, Enschede, the Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands; Corresponding author. Clinical Neurophysiology, TechMed Centre, University of Twente, Enschede, the Netherlands.Clinical Neurophysiology, TechMed Centre, University of Twente, Enschede, the NetherlandsDepartment of Neurology, Radboudumc, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, the NetherlandsClinical Neurophysiology, TechMed Centre, University of Twente, Enschede, the Netherlands; Sir Peter Mansfield Imaging Center, School of Physics, University of Nottingham, Nottingham, United KingdomClinical Neurophysiology, TechMed Centre, University of Twente, Enschede, the Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, the NetherlandsLimburg Brain Injury Center, Maastricht University, Maastricht, the Netherlands; Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the NetherlandsDepartment of Cardiology, Radboudumc, Nijmegen, the NetherlandsDepartment of Cardiology, Maastricht UMC+, Maastricht, the NetherlandsDepartment of Neurology, Radboudumc, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University, Nijmegen, the NetherlandsClinical Neurophysiology, TechMed Centre, University of Twente, Enschede, the Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, the NetherlandsIntroduction: Half of all cardiac arrest patients experience long-term cognitive impairment. Identifying patients at risk is challenging and underlying mechanisms are incompletely understood. Since postanoxic encephalopathy is diffuse, measures of global network organization might contribute to identifying these patients at risk. We studied MRI-based whole-brain and subnetwork topology in relation to short- and long-term cognitive outcomes after cardiac arrest. Methods: We performed a multicenter prospective cohort study in cardiac arrest survivors. Patients underwent resting-state functional MRI during hospitalization (within one month after cardiac arrest). We analyzed 264 regions of interest using Power's atlas, extracting mean timeseries and calculating pairwise connectivity with Pearson's correlation. Overall functional connectivity, global efficiency, clustering coefficient, and modularity were calculated for the whole brain and five subnetworks. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) during hospitalization, at three, and twelve months, and using neuropsychological examination at twelve months. Mixed effects models were used to examine relationships between topology measures and cognitive outcomes. We corrected for multiple testing. Results: We included 80 patients (age 60 ± 11 years, 70 (90%) male). Our analyses showed consistent relations between various topology measures of the sensory/somatomotor network (SSN) and MoCA score during hospitalization and memory, attention, and executive functioning at twelve months follow up. After correction for multiple testing, we found no statistically significant relations between whole-brain and subnetwork graph measures and cognitive outcomes. Conclusion: Early whole brain functional topology was not related to short- or long-term cognitive outcome after cardiac arrest in this analysis. Potential relations between SSN topology and cognitive outcome point towards spatial heterogeneity of postanoxic encephalopathy. Possible predictive values of SSN structure or function need further investigation.http://www.sciencedirect.com/science/article/pii/S2666956025000121Cardiac arrestFunctional magnetic resonance imagingCognitionResuscitationbrain topologyGraph theory
spellingShingle Marlous M.L.H. Verhulst
Puck Lange
Anil Man Tuladhar
Prejaas Tewarie
Pauline C.W. van Gils
Caroline van Heugten
Judith Bonnes
Thijs Delnoij
Rick Helmich
Jeannette Hofmeijer
Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI data
NeuroImage: Reports
Cardiac arrest
Functional magnetic resonance imaging
Cognition
Resuscitation
brain topology
Graph theory
title Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI data
title_full Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI data
title_fullStr Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI data
title_full_unstemmed Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI data
title_short Brain topology and cognitive outcomes after cardiac arrest: A graph theoretical analysis of fMRI data
title_sort brain topology and cognitive outcomes after cardiac arrest a graph theoretical analysis of fmri data
topic Cardiac arrest
Functional magnetic resonance imaging
Cognition
Resuscitation
brain topology
Graph theory
url http://www.sciencedirect.com/science/article/pii/S2666956025000121
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