A pilot study of gray matter volume and function changes in patients after cardiopulmonary resuscitation / 中华急诊医学杂志

ABSTRACT

Objective:To explore the structural and functional alterations of related brain regions in patients after cardiopulmonary resuscitation (CPR) by brain magnetic resonance imaging (MRI).Methods:A single-center, observational, cross-sectional study design was used. Patients who had brain MRI scans during hospitalization between July 2020 and July 2021 in Emergency Department of the First Affiliated Hospital of Nanjing Medical University and had good neurologic outcomes were consecutive enrolled in this study. The healthy control (HC) group consisted of age- and sex-matched volunteers. The demographic and clinical data were recorded. The modified Rankin Scale (mRS) was used to check the recovery and degree of continued disabilities when patients performed MRI. Montreal cognitive assessment (MoCA) was used to assess cognitive functions. The analyses of voxel-based morphometry (VBM) and fractional amplitude of low-frequency fluctuation (fALFF) were conducted. After data preprocessing, comparison of gray matter volume (GMV) and fALFF values between the case group and HC group were carried out, and the information of different brain regions was obtained. Partial correlation analyses were performed to evaluate the correlation between the image parameters of different clusters and clinical parameters.Results:Totally 13 patients were enrolled in this study and 13 were in the HC group. All patients achieved good neurologic outcome; mRS was 3 in 1 case, 2 in 3 cases, and 1 in 5 cases during MEI examination. The case group showed significantly lower MoCA score compared with the HC group ( P<0.001). There were significantly decreased GMVs in the right inferior frontal gyrus, superior temporal gyrus, left superior temporal gyrus, and transverse temporal gyrus in the case group. The patients showed significantly decreased fALFF values in the left postcentral gyrus and precentral gyrus, while increased fALFF values in the right putamen than the HC group (voxel-level P<0.001 and cluster-level P<0.05 with GRF correction). In addition, mean fALFF value in the right putamen was negatively correlated with MoCA score in the case group ( r=-0.710, P=0.021). Conclusions:Patients after CPR may have GMVs and neuronal spontaneous activity changes in some brain regions, and VBM and fALFF methods can be used to objectively evaluate the impaired brain functional activity in patients after successful CPR.