Functional connectivity in resting-state networks relates to short-term global cognitive functioning in cardiac arrest survivors

Marlous M L H Verhulst*, Hanneke M Keijzer, Pauline C W van Gils, Caroline M van Heugten, Frederick J A Meijer, Bart A R Tonino, Judith L Bonnes, Thijs S R Delnoij, Jeannette Hofmeijer, Rick C Helmich

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Long-term cognitive impairment is common in cardiac arrest survivors. Screening to identify patients at risk is recommended. Functional magnetic resonance brain imaging (fMRI) holds potential to contribute to prediction of cognitive outcomes. In this study, we investigated the possible value of early changes in resting-state networks for predicting short and long-term cognitive functioning of cardiac arrest survivors. We performed a prospective multicenter cohort study in cardiac arrest survivors in three Dutch hospitals. Resting-state fMRI scans were acquired within a month after cardiac arrest. We primarily focused on functional connectivity within the default-mode network (DMN) and salience network (SN), and additionally explored functional connectivity in seven other networks. Cognitive outcome was measured using the Montreal Cognitive Assessment (MoCA) during hospital admission and at 3 and 12 months, and by neuropsychological examination (NPE) at 12 months. We tested mixed effects models to evaluate the value of connectivity within the networks for predicting global cognitive outcomes at the three time points, and long-term cognitive outcomes in the memory, attention, and executive functioning domains. We included 80 patients (age 60 ± 11 years, 72 (90%) male). MoCA scores increased significantly between hospital admission and 3 months (ΔMoCA hospital-3M = 2.89, p < 0.01), but not between 3 and 12 months (ΔMoCA 3M–12M = 0.38, p = 0.52). Connectivity within the DMN, SN, and dorsal attention network (DAN) was positively related to global cognitive functioning during hospital admission (β DMN = 0.85, p = 0.03; β SN = 1.48, p < 0.01; β DAN = 0.96, p = 0.01), but not at 3 and 12 months. Network connectivity was also unrelated to long-term memory, attention, or executive functioning. Resting-state functional connectivity in the DMN, SN, and DAN measured in the first month after cardiac arrest is related to short-term global, but not long-term global or domain-specific cognitive performance of survivors. These results do not support the value of functional connectivity within these RSNs for prediction of long-term cognitive performance after cardiac arrest.

Original languageEnglish
Article numbere26769
Number of pages11
JournalHuman Brain Mapping
Volume45
Issue number15
DOIs
Publication statusPublished - 24 Oct 2024

Keywords

  • cardiac arrest
  • cognition
  • functional MRI
  • functional connectivity
  • resting-state networks
  • Humans
  • Male
  • Female
  • Middle Aged
  • Heart Arrest/complications physiopathology diagnostic imaging
  • Aged
  • Magnetic Resonance Imaging
  • Cognitive Dysfunction/physiopathology etiology diagnostic imaging
  • Connectome
  • Nerve Net/diagnostic imaging physiopathology
  • Default Mode Network/diagnostic imaging physiopathology
  • Survivors
  • Prospective Studies
  • Executive Function/physiology

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