Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

July 28, 2020; 95 (4) Article

MRI–EEG correlation for outcome prediction in postanoxic myoclonus

A multicenter study

Isabelle Beuchat, Adithya Sivaraju, Edilberto Amorim, Emily J. Gilmore, View ORCID ProfileVincent Dunet, Andrea O. Rossetti, View ORCID ProfileM. Brandon Westover, Liangge Hsu, Benjamin M. Scirica, Danuzia Silva, Kathleen Tang, Jong Woo Lee
First published June 1, 2020, DOI: https://doi.org/10.1212/WNL.0000000000009610
Isabelle Beuchat
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Adithya Sivaraju
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Edilberto Amorim
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Emily J. Gilmore
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vincent Dunet
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Vincent Dunet
Andrea O. Rossetti
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
M. Brandon Westover
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for M. Brandon Westover
Liangge Hsu
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Benjamin M. Scirica
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Danuzia Silva
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kathleen Tang
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jong Woo Lee
From the Department of Clinical Neuroscience, Neurology Service (I.B., A.O.R.), and Department of Diagnostic and Interventional Radiology (V.D.), Lausanne University Hospital and University of Lausanne, Switzerland; Division of Clinical Neurophysiology and Comprehensive Epilepsy Center (A.S., E.J.G.), Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Neurology (E.A., M.B.W.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology (L.H.), Medicine/Cardiology (B.S., D.S.), and Neurology (I.B., K.T., J.W.L.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Short Form
Citation
MRI–EEG correlation for outcome prediction in postanoxic myoclonus
A multicenter study
Isabelle Beuchat, Adithya Sivaraju, Edilberto Amorim, Emily J. Gilmore, Vincent Dunet, Andrea O. Rossetti, M. Brandon Westover, Liangge Hsu, Benjamin M. Scirica, Danuzia Silva, Kathleen Tang, Jong Woo Lee
Neurology Jul 2020, 95 (4) e335-e341; DOI: 10.1212/WNL.0000000000009610

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
493

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective To examine the prognostic ability of the combination of EEG and MRI in identifying patients with good outcome in postanoxic myoclonus (PAM) after cardiac arrest (CA).

Methods Adults with PAM who had an MRI within 20 days after CA were identified in 4 prospective CA registries. The primary outcome measure was coma recovery to command following by hospital discharge. Clinical examination included brainstem reflexes and motor activity. EEG was assessed for best background continuity, reactivity, presence of epileptiform activity, and burst suppression with identical bursts (BSIB). MRI was examined for presence of diffusion restriction or fluid-attenuated inversion recovery changes consistent with anoxic brain injury. A prediction model was developed using optimal combination of variables.

Results Among 78 patients, 11 (14.1%) recovered at discharge and 6 (7.7%) had good outcome (Cerebral Performance Category < 3) at 3 months. Patients who followed commands were more likely to have pupillary and corneal reflexes, flexion or better motor response, EEG continuity and reactivity, no BSIB, and no anoxic injury on MRI. The combined EEG/MRI variable of continuous background and no anoxic changes on MRI was associated with coma recovery at hospital discharge with sensitivity 91% (95% confidence interval [CI], 0.59–1.00), specificity 99% (95% CI, 0.92–1.00), positive predictive value 91% (95% CI, 0.59–1.00), and negative predictive value 99% (95% CI, 0.92–1.00).

Conclusions EEG and MRI are complementary and identify both good and poor outcome in patients with PAM with high accuracy. An MRI should be considered in patients with myoclonus showing continuous or reactive EEGs.

Glossary

ADC=
apparent diffusion coefficient;
AUC=
area under the receiver operating characteristic curve;
BSIB=
burst suppression with identical bursts;
CA=
cardiac arrest;
CI=
confidence interval;
CPC=
Cerebral Performance Category;
PAM=
postanoxic myoclonus;
TTM=
targeted temperature management;
WLST=
withdrawal of life-sustaining treatment

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 149

  • Received August 15, 2019.
  • Accepted in final form January 27, 2020.
  • © 2020 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Letters: Rapid online correspondence

  • Author response: MRI‐EEG correlation for outcome prediction in postanoxic myoclonus: A multicenter study
    • Isabelle Beuchat, Neurologist, Centre Hospitalier Universitaire Vaudois (CHUV)
    • Jong Woo Lee, Neurologist, Brigham and Women's Hospital
    Submitted June 16, 2020
  • Reader response: MRI‐EEG correlation for outcome prediction in postanoxic myoclonus: A multicenter study
    • Calixto Machado, Neurologist, AAN Corresponding Fellow, Insttitute of Neurology and Neurosurgery (Havana, Cuba)
    Submitted June 12, 2020
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Glossary
    • Methods
    • Results
    • Discussion
    • Study funding
    • Disclosure
    • Appendix Authors
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
Advertisement

SARS-CoV-2 Vaccination Safety in Guillain-Barré Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, and Multifocal Motor Neuropathy

Dr. Jeffrey Allen and Dr. Nicholas Purcell

► Watch

Related Articles

  • MRI and EEG accurately classify favorable prognosis for patients with postanoxic myoclonusParadigm shift

Topics Discussed

  • MRI
  • Prognosis
  • Coma

Alert Me

  • Alert me when eletters are published

Recommended articles

  • Article
    EEG reactivity testing for prediction of good outcome in patients after cardiac arrest
    Marjolein M. Admiraal, Janneke Horn, Jeannette Hofmeijer et al.
    Neurology, July 10, 2020
  • Article
    Prediction of regaining consciousness despite an early epileptiform EEG after cardiac arrest
    Giuseppina Barbella, Jong Woo Lee, Vincent Alvarez et al.
    Neurology, March 25, 2020
  • Resident and Fellow Section
    Clinical Reasoning: Prognostication after cardiac arrest
    What do we really know?
    Rachel B. Beekman, David M. Greer, Daniel C. Brooks et al.
    Neurology, November 13, 2017
  • Article
    Early EEG contributes to multimodal outcome prediction of postanoxic coma
    Jeannette Hofmeijer, Tim M.J. Beernink, Frank H. Bosch et al.
    Neurology, June 12, 2015
Neurology: 100 (13)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise