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Early Quantitative Gamma-Band EEG Marker is Associated with Outcomes After Cardiac Arrest and Targeted Temperature Management

  • Translational Research
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Abstract

Background

Brain recovery after cardiac arrest (CA) is sensitive to temperature. Yet the effect of temperature management on different EEG frequency bands has not been elucidated. A novel quantitative EEG algorithm, sub-band information quantity (SIQ), was applied to evaluate EEG recovery and outcomes after CA.

Methods

Twenty-four Wistar rats undergoing 7-min CA were randomly assigned to immediate hypothermia (32–34 °C), normothermia (36.5–37.5 °C), or hyperthermia (38.5–39.5 °C) (n = 8). EEG was recorded continuously for the first 8 h and then for serial 30-min epochs daily. The neurologic deficit score (NDS) at 72-h was the primary functional outcome. Another four rats without brain injury were added as a control.

Results

Better recovery of gamma-band SIQ was found in the hypothermia group (0.60 ± 0.03) compared with the normothermia group (0.40 ± 0.03) (p < 0.01) and in the normothermia group compared with the hyperthermia group (0.34 ± 0.03) (p < 0.05). The NDS was also improved in the lower temperature groups: hypothermia [median (25th, 75th), 74 (61, 74)] versus normothermia [49 (47, 61)] versus hyperthermia [43 (0, 50)] (p < 0.01). Throughout the 72-h experiment, the gamma-band SIQ showed the strongest correlation at every time point (ranging 0.520–0.788 from 30-min to 72-h post-resuscitation, all p < 0.05) whereas the delta-band SIQ had poor correlation with the 72-h NDS. No significant difference of sub-band EEG was found with temperature manipulation alone.

Conclusions

Recovery of gamma-band SIQ-qEEG was strongly associated with functional outcomes after CA. Induced hypothermia was associated with faster recovery of gamma-band SIQ and improved functional outcomes. Targeted temperature management primarily affected gamma frequency oscillations but not delta rhythm.

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Acknowledgments

The work was supported by R01HL118084 from NIH (to XJ) and 09SDG2110140 from American Heart Association (to XJ). Deng and Jia were supported by NIH R01HL118084 and AHA 09SDG2110140. Dr. Jia was supported in partial by Maryland Stem Cell Research Fund (2013-MSCRFE-146-00) (to XJ).

Conflict of interest

The authors declare no competing financial interests.

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Authors and Affiliations

  1. Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Ruoxian Deng, Leanne Moon Young & Xiaofeng Jia

  2. Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF building 559, Baltimore, MD, 21201, USA

    Ruoxian Deng, Leanne Moon Young & Xiaofeng Jia

  3. Department of Medicine, The University of Hawaii John A. Burns School of Medicine, Honolulu, HI, 96813, USA

    Matthew A. Koenig

  4. Neuroscience Institute, The Queen’s Medical Center, Honolulu, HI, 96813, USA

    Matthew A. Koenig

  5. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Xiaofeng Jia

  6. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, 21201, USA

    Xiaofeng Jia

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  1. Ruoxian Deng
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Correspondence to Xiaofeng Jia.

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Deng, R., Koenig, M.A., Young, L.M. et al. Early Quantitative Gamma-Band EEG Marker is Associated with Outcomes After Cardiac Arrest and Targeted Temperature Management. Neurocrit Care 23, 262–273 (2015). https://doi.org/10.1007/s12028-015-0157-2

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