{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:59:18Z","timestamp":1791910758880,"version":"4.3.4"},"reference-count":62,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate autonomic nervous system activity measured by brain\u2013heart interactions in comatose patients after cardiac arrest in relation to the severity and prognosis of hypoxic\u2013ischemic brain injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Strength and complexity of bidirectional interactions between EEG frequency bands (delta, theta, and alpha) and ECG heart rate variability frequency bands (low frequency, LF and high frequency, HF) were computed using a synthetic data generation model. Primary outcome was the severity of brain injury, assessed by (i) standardized qualitative EEG classification, (ii) somatosensory evoked potentials (N20), and (iii) neuron\u2010specific enolase levels. Secondary outcome was the 3\u2010month neurological status, assessed by the Cerebral Performance Category score [good (1\u20132) vs. poor outcome (3\u20134\u20135)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between January 2007 and July 2021, 181 patients were admitted to ICU for a resuscitated cardiac arrest. Poor neurological outcome was observed in 134 patients (74%). Qualitative EEG patterns suggesting high severity were associated with decreased LF\/HF. Severity of EEG changes were proportional to higher absolute values of brain\u2010to\u2010heart coupling strength (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02 for all brain\u2010to\u2010heart frequencies) and lower values of alpha\u2010to\u2010HF complexity (<jats:italic>p<\/jats:italic>\u2009=\u20090.049). Brain\u2010to\u2010heart coupling strength was significantly higher in patients with bilateral absent N20 and correlated with neuron\u2010specific enolase levels at Day 3. This aberrant brain\u2010to\u2010heart coupling (increased strength and decreased complexity) was also associated with 3\u2010month poor neurological outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Our results suggest that autonomic dysfunctions may well represent hypoxic\u2013ischemic brain injury post cardiac arrest pathophysiology. These results open avenues for integrative monitoring of autonomic functioning in critical care patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.52000","type":"journal-article","created":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T06:44:26Z","timestamp":1705733066000},"page":"866-882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Aberrant brain\u2013heart coupling is associated with the severity of post cardiac arrest brain injury"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9071-3415","authenticated-orcid":false,"given":"Bertrand","family":"Hermann","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Medical Intensive Care Unit HEGP Hospital, Assistance Publique \u2010 H\u00f4pitaux de Paris\u2010Centre (APHP.Centre)  Paris France"},{"name":"INSERM UMR 1266, Institut de Psychiatrie 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