title: Electrophysiological Monitoring of Brain Injury and Recovery after Cardiac Arrest.
abstract: Reliable prognostic methods for cerebral functional outcome of post cardiac-arrest (CA) patients are necessary, especially since therapeutic hypothermia (TH) as a standard treatment. Traditional neurophysiological prognostic indicators, such as clinical examination and chemical biomarkers, may result in indecisive outcome predictions and do not directly reflect neuronal activity, though they have remained the mainstay of clinical prognosis. The most recent advances in electrophysiological methods--electroencephalography (EEG) pattern, evoked potential (EP) and cellular electrophysiological measurement--were developed to complement these deficiencies, and will be examined in this review article. EEG pattern (reactivity and continuity) provides real-time and accurate information for early-stage (particularly in the first 24 h) hypoxic-ischemic (HI) brain injury patients with high sensitivity. However, the signal is easily affected by external stimuli, thus the measurements of EP should be combined with EEG background to validate the predicted neurologic functional result. Cellular electrophysiology, such as multi-unit activity (MUA) and local field potentials (LFP), has strong potential for improving prognostication and therapy by offering additional neurophysiologic information to understand the underlying mechanisms of therapeutic methods. Electrophysiology provides reliable and precise prognostication on both global and cellular levels secondary to cerebral injury in cardiac arrest patients treated with TH.
authors.affiliation: Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. rdeng3@jhu.edu.|Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA. rdeng3@jhu.edu.
authors.forename: Ruoxian
authors.initials: R
authors.lastname: Deng
authors.affiliation: Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. wei.xiong@UHhospitals.org.|Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA. wei.xiong@UHhospitals.org.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. xjia@smail.umaryland.edu.|Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA. xjia@smail.umaryland.edu.|Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. xjia@smail.umaryland.edu.|Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA. xjia@smail.umaryland.edu.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Jia
mesh_terms: D015415:Biomarkers; D001927:Brain Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology* / Q000534:rehabilitation; D004569:Electroencephalography; D055724:Electrophysiological Phenomena; D005071:Evoked Potentials; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D020127:Recovery of Function
chemical_list: D015415:Biomarkers
keywords: EEG; cardiac arrest; electrophysiology; evoked potentials; hypothermia; ischemic brain injury; prognostication