{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:22:15Z","timestamp":1792178535265,"version":"4.4.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"State Research Funding, Finland"},{"DOI":"10.13039\/501100005633","name":"Syd\u00e4ntutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"crossref"}]},{"name":"University of Turku (UTU) including Turku University Central Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuroradiology"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>We compared the predictive accuracy of early-phase brain diffusion tensor imaging (DTI), proton magnetic resonance spectroscopy (1H-MRS), and serum neuron-specific enolase (NSE) against the motor score and epileptic seizures (ES) for poor neurological outcome after out-of-hospital cardiac arrest (OHCA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The predictive accuracy of DTI, 1H-MRS, and NSE along with motor score at 72\u00a0h and ES for the poor neurological outcome (modified Rankin Scale, mRS, 3\u2009\u2212\u20096) in 92 comatose OHCA patients at 6\u00a0months was assessed by area under the receiver operating characteristic curve (AUROC). Combined models of the variables were included as exploratory.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The predictive accuracy of fractional anisotropy (FA) of DTI (AUROC 0.73, 95% CI 0.62\u20130.84), total <jats:italic>N<\/jats:italic>-acetyl aspartate\/total creatine (tNAA\/tCr) of 1H-MRS (0.78 (0.68\u2009\u2212\u20090.88)), or NSE at 72\u00a0h (0.85 (0.76\u2009\u2212\u20090.93)) was not significantly better than motor score at 72\u00a0h (0.88 (95% CI 0.80\u20130.96)). The addition of FA and tNAA\/tCr to a combination of NSE, motor score, and ES provided a small but statistically significant improvement in predictive accuracy (AUROC 0.92 (0.85\u20130.98) vs 0.98 (0.96\u20131.00), <jats:italic>p<\/jats:italic>\u2009=\u20090.037).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>None of the variables (FA, tNAA\/tCr, ES, NSE at 72\u00a0h, and motor score at 72\u00a0h) differed significantly in predicting poor outcomes in this patient group. Early-phase quantitative neuroimaging provided a statistically significant improvement for the predictive value when combined with ES and motor score with or without NSE. However, in clinical practice, the additional value is small, and considering the costs and challenges of imaging in this patient group, early-phase DTI\/MRS cannot be recommended for routine use.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ClinicalTrials.gov NCT00879892, April 13, 2009.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00234-022-03063-z","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T07:02:36Z","timestamp":1665990156000},"page":"349-360","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of the prognostic value of early-phase proton magnetic resonance spectroscopy and diffusion tensor imaging with serum neuron-specific enolase at 72\u00a0h in comatose survivors of out-of-hospital cardiac arrest\u2014a substudy of the XeHypotheca trial"],"prefix":"10.1007","volume":"65","author":[{"given":"Kalle","family":"Koskensalo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Virtanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jani","family":"Saunavaara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riitta","family":"Parkkola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruut","family":"Laitio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"Arola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja","family":"Hynninen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Silvasti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eija","family":"Nukarinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Martola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heli M.","family":"Silvennoinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjaana","family":"Tiainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risto O.","family":"Roine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Scheinin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Saraste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervyn","family":"Maze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tero","family":"Vahlberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2617-9358","authenticated-orcid":false,"given":"Timo T.","family":"Laitio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the XeHYPOTHECA Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,17]]},"reference":[{"key":"3063_CR1","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.resuscitation.2016.06.004","volume":"105","author":"JT Gr\u00e4sner","year":"2016","unstructured":"Gr\u00e4sner JT, Lefering R, Koster RW, Masterson S, B\u00f6ttiger BW, Herlitz J et al (2016) EuReCa ONE Collaborators. EuReCa ONE-27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe. Resuscitation 105:188\u201395","journal-title":"Resuscitation"},{"issue":"23","key":"3063_CR2","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1056\/NEJMoa1310519","volume":"369","author":"N Nielsen","year":"2013","unstructured":"Nielsen N, Wetterslev J, Cronberg T, Erlinge D, Gasche Y, Hassager C et al (2013) TTM trial investigators. targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest. N Engl J Med 369(23):2197\u2013206","journal-title":"N Engl J Med"},{"issue":"3","key":"3063_CR3","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.resuscitation.2012.09.015","volume":"84","author":"I Dragancea","year":"2013","unstructured":"Dragancea I, Rundgren M, Englund E, Friberg H, Cronberg T (2013) The influence of induced hypothermia and delayed prognostication on the mode of death after cardiac arrest. Resuscitation 84(3):337\u2013342","journal-title":"Resuscitation"},{"key":"3063_CR4","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.resuscitation.2021.02.012","volume":"161","author":"JP Nolan","year":"2021","unstructured":"Nolan JP, Sandroni C, B\u00f6ttiger BW, Cariou A, Cronberg T, Friberg H et al (2021) European Resuscitation Council and European Society of Intensive Care Medicine Guidelines 2021: post-resuscitation care. Resuscitation 161:220\u2013269","journal-title":"Resuscitation"},{"issue":"6","key":"3063_CR5","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/S1474-4422(16)00015-6","volume":"15","author":"AO Rossetti","year":"2016","unstructured":"Rossetti AO, Rabinstein AA, Oddo M (2016) Neurological prognostication of outcome in patients in coma after cardiac arrest. Lancet Neurol 15(6):597\u2013609","journal-title":"Lancet Neurol"},{"issue":"4","key":"3063_CR6","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1002\/ana.21632","volume":"65","author":"CA Wijman","year":"2009","unstructured":"Wijman CA, Mlynash M, Caulfield AF, Hsia AW, Eyngorn I, Bammer R et al (2009) Prognostic value of brain diffusion-weighted imaging after cardiac arrest. Ann Neurol 65(4):394\u2013402","journal-title":"Ann Neurol"},{"issue":"4","key":"3063_CR7","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1161\/STROKEAHA.112.658328","volume":"44","author":"C Matute","year":"2013","unstructured":"Matute C, Domercq M, Perez-Samartin A, Ransom BR (2013) Protecting white matter from stroke injury. Stroke 44(4):1204\u20131211","journal-title":"Stroke"},{"issue":"6","key":"3063_CR8","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1097\/ALN.0b013e318275148c","volume":"117","author":"CE Luyt","year":"2012","unstructured":"Luyt CE, Galanaud D, Perlbarg V, Vanhaudenhuyse A, Stevens RD, Gupta R et al (2012) Neuro Imaging for Coma Emergence and Recovery Consortium. Diffusion tensor imaging to predict long-term outcome after cardiac arrest: a bicentric pilot study. Anesthesiology 117(6):1311\u201321","journal-title":"Anesthesiology"},{"issue":"4","key":"3063_CR9","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1001\/archneur.55.4.489","volume":"55","author":"F Federico","year":"1998","unstructured":"Federico F, Simone IL, Lucivero V, Giannini P, Laddomada G, Mezzapesa DM et al (1998) Prognostic value of proton magnetic resonance spectroscopy in ischemic stroke. Arch Neurol 55(4):489\u2013494","journal-title":"Arch Neurol"},{"issue":"7","key":"3063_CR10","first-page":"1546","volume":"27","author":"JLY Cheong","year":"2006","unstructured":"Cheong JLY, Cady EB, Penrice J, Wyatt JS, Cox IJ, Robertson NJ (2006) Proton MR spectroscopy in neonates with perinatal cerebral hypoxic-ischemic injury: metabolite peak-area ratios, relaxation times, and absolute concentrations. Am J Neuroradiol 27(7):1546\u20131554","journal-title":"Am J Neuroradiol"},{"issue":"4","key":"3063_CR11","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/S1474-4422(18)30027-9","volume":"17","author":"L Velly","year":"2018","unstructured":"Velly L, Perlbarg V, Boulier T, Adam N, Delphine S, Luyt CE et al (2018) MRI-COMA Investigators. Use of brain diffusion tensor imaging for the prediction of long-term neurological outcomes in patients after cardiac arrest: a multicentre, international, prospective, observational, cohort study. Lancet Neurol 17(4):317\u201326","journal-title":"Lancet Neurol"},{"issue":"2","key":"3063_CR12","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1046\/j.1471-4159.2001.00285.x","volume":"77","author":"C Demougeot","year":"2001","unstructured":"Demougeot C, Garnier P, Mossiat C, Bertrand N, Giroud M, Beley A et al (2001) N-Acetylaspartate, a marker of both cellular dysfunction and neuronal loss: its relevance to studies of acute brain injury. J Neurochem 77(2):408\u2013415","journal-title":"J Neurochem"},{"issue":"1","key":"3063_CR13","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1002\/ajmg.a.36207","volume":"164A","author":"GE Utine","year":"2014","unstructured":"Utine GE, Akp\u0131nar B, Arslan U, Kiper P\u00d6, Volkan-Salanc\u0131 B, Alanay Y et al (2014) Neurochemical evaluation of brain function with 1H magnetic resonance spectroscopy in patients with fragile X syndrome. Am J Med Genet A 164A(1):99\u2013105","journal-title":"Am J Med Genet A"},{"issue":"9","key":"3063_CR14","doi-asserted-by":"publisher","first-page":"2467","DOI":"10.1161\/STROKEAHA.107.507020","volume":"39","author":"S Mu\u00f1oz Maniega","year":"2008","unstructured":"Mu\u00f1oz Maniega S, Cvoro V, Armitage PA, Marshall I, Bastin ME, Wardlaw JM (2008) Choline and creatine are not reliable denominators for calculating metabolite ratios in acute ischemic stroke. Stroke 39(9):2467\u20132469","journal-title":"Stroke"},{"key":"3063_CR15","doi-asserted-by":"publisher","first-page":"h5527","DOI":"10.1136\/bmj.h5527","volume":"351","author":"PM Bossuyt","year":"2015","unstructured":"Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L et al (2015) STARD Group STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ 351:h5527","journal-title":"BMJ"},{"issue":"4","key":"3063_CR16","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1016\/j.neuroimage.2006.02.024","volume":"31","author":"SM Smith","year":"2006","unstructured":"Smith SM, Jenkinson M, Johansen-Berg H, Rueckert D, Nichols TE, Mackay CE et al (2006) Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data. Neuroimage 31(4):1487\u20131505","journal-title":"Neuroimage"},{"issue":"2","key":"3063_CR17","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/j.neuroimage.2011.09.015","volume":"62","author":"M Jenkinson","year":"2012","unstructured":"Jenkinson M, Beckmann CF, Behrens TE, Woolrich MW, Smith SM (2012) FSL Neuroimage 62(2):782\u2013790","journal-title":"FSL Neuroimage"},{"issue":"6","key":"3063_CR18","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1002\/mrm.1910300604","volume":"30","author":"S Provencher","year":"1993","unstructured":"Provencher S (1993) Estimation of metabolite concentrations from localized in-vivo proton Nmr-spectra. Magn Reson Med 30(6):672\u2013679","journal-title":"Magn Reson Med"},{"issue":"1","key":"3063_CR19","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.ajem.2012.06.008","volume":"31","author":"ZR Tang","year":"2013","unstructured":"Tang ZR, Li CS, Zhao H, Gong P, Zhang MY, Su ZY et al (2013) Effects of hypothermia on brain injury assessed by magnetic resonance imaging after cardiopulmonary resuscitation in a porcine model of cardiac arrest. Am J Emerg Med 31(1):86\u201393","journal-title":"Am J Emerg Med"},{"issue":"1","key":"3063_CR20","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1148\/radiol.2301021640","volume":"230","author":"S Wakana","year":"2004","unstructured":"Wakana S, Jiang H, Nagae-Poetscher LM, van Zijl PC, Mori S (2004) Fiber tract-based atlas of human white matter anatomy. Radiology 230(1):77\u201387","journal-title":"Radiology"},{"key":"3063_CR21","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.resuscitation.2013.06.020","volume":"84","author":"C Sandroni","year":"2013","unstructured":"Sandroni C, Cavallaro F, Callaway CW, Sanna T, D\u2019Arrigo S, Kuiper M et al (2013) Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest: a systematic review and meta-analysis. Part 2: patients treated with therapeutic hypothermia. Resuscitation 84:1324\u201338","journal-title":"Resuscitation"},{"key":"3063_CR22","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1016\/j.resuscitation.2013.05.013","volume":"84","author":"C Sandroni","year":"2013","unstructured":"Sandroni C, Cavallaro F, Callaway CW, Sanna T, D\u2019Arrigo S, Kuiper M et al (2013) Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest: a systematic review and meta-analysis. Part 1: patients not treated with therapeutic hypothermia. Resuscitation 84:1310\u201323","journal-title":"Resuscitation"},{"issue":"7","key":"3063_CR23","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1097\/CCM.0000000000002335","volume":"45","author":"KJ Streitberger","year":"2017","unstructured":"Streitberger KJ, Leithner C, Wattenberg M, Tonner PH, Hasslacher J, Joannidis M et al (2017) Neuron-specific enolase predicts poor outcome after cardiac arrest and targeted temperature management: a multicenter study on 1,053 patients. Crit Care Med 45(7):1145\u20131151","journal-title":"Crit Care Med"},{"key":"3063_CR24","doi-asserted-by":"publisher","first-page":"2104","DOI":"10.1016\/j.jacc.2015.03.538","volume":"65","author":"P Stammet","year":"2015","unstructured":"Stammet P, Collignon O, Hassager C, Wise MP, Hovdenes J, \u00c5neman A et al (2015) TTM-Trial Investigators. Neuron-specific enolase as a predictor of death or poor neurological outcome after out-of-hospital cardiac arrest and targeted temperature management at 33 \u00b0C and 36 \u00b0C. J Am Coll Cardiol 65:2104\u201314","journal-title":"J Am Coll Cardiol"},{"issue":"7\u20138","key":"3063_CR25","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1002\/nbm.782","volume":"15","author":"C Beaulieu","year":"2002","unstructured":"Beaulieu C (2002) The basis of anisotropic water diffusion in the nervous system - a technical review. NMR Biomed 15(7\u20138):435\u2013455","journal-title":"NMR Biomed"},{"issue":"1","key":"3063_CR26","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1161\/01.STR.0000252127.07428.9c","volume":"38","author":"Y Liu","year":"2007","unstructured":"Liu Y, D\u2019Arceuil HE, Westmoreland S, He J, Duggan M, Gonzalez RG, Pryor J et al (2007) Serial diffusion tensor MRI after transient and permanent cerebral ischemia in nonhuman primates. Stroke 38(1):138\u2013145","journal-title":"Stroke"},{"issue":"23","key":"3063_CR27","doi-asserted-by":"publisher","first-page":"2452","DOI":"10.1161\/CIRCULATIONAHA.108.190652","volume":"118","author":"RW Neumar","year":"2008","unstructured":"Neumar RW, Nolan JP, Adrie C, Aibiki M, Berg RA, B\u00f6ttiger BW et al (2008) Post-cardiac arrest syndrome epidemiology, pathophysiology, treatment, and prognostication a consensus statement from the international liaison committee on resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa);the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care;the Council on Clinical Cardiology; and the Stroke Council. Circulation 118(23):2452\u20132483","journal-title":"Circulation"},{"issue":"12","key":"3063_CR28","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1016\/j.resuscitation.2013.07.009","volume":"84","author":"AV Grossestreuer","year":"2013","unstructured":"Grossestreuer AV, Abella BS, Leary M, Perman SM, Fuchs BD, Kolansky DM et al (2013) Time to awakening and neurologic outcome in therapeutic hypothermia-treated cardiac arrest patients. Resuscitation 84(12):1741\u20131746","journal-title":"Resuscitation"},{"issue":"2","key":"3063_CR29","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.resuscitation.2013.10.030","volume":"85","author":"B Gold","year":"2014","unstructured":"Gold B, Puertas L, Davis SP, Metzger A, Yannopoulos D, Oakes DA et al (2014) Awakening after cardiac arrest and post resuscitation hypothermia: are we pulling the plug too early? Resuscitation 85(2):211\u2013214","journal-title":"Resuscitation"},{"issue":"3","key":"3063_CR30","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/S0730-725X(98)00192-1","volume":"17","author":"F Zelaya","year":"1999","unstructured":"Zelaya F, Flood N, Chalk JB, Wang D, Doddrell DM, Strugnell W et al (1999) An evaluation of the time dependence of the anisotropy of the water diffusion tensor in acute human ischemia. Magn Reson Imaging 17(3):331\u2013348","journal-title":"Magn Reson Imaging"},{"key":"3063_CR31","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1016\/j.ajem.2016.05.063","volume":"34","author":"BK Lee","year":"2016","unstructured":"Lee BK, Kim WY, Shin J, Oh JS, Wee JH, Cha KC et al (2016) Korean Hypothermia Network Investigators. Prognostic value of gray matter to white matter ratio in hypoxic and non-hypoxic cardiac arrest with non-cardiac etiology. Am J Emerg Med 34:1583\u20138","journal-title":"Am J Emerg Med"},{"key":"3063_CR32","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.resuscitation.2014.11.031","volume":"88","author":"JS Park","year":"2015","unstructured":"Park JS, Lee SW, Kim H, Min JH, Kang JH, Yi KS et al (2015) Efficacy of diffusion-weighted magnetic resonance imaging performed before therapeutic hypothermia in predicting clinical outcome in comatose cardiopulmonary arrest survivors. Resuscitation 88:132\u2013137","journal-title":"Resuscitation"},{"issue":"8","key":"3063_CR33","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1161\/01.STR.29.8.1618","volume":"29","author":"J Wardlaw","year":"1998","unstructured":"Wardlaw J, Marshall I, Wild J, Dennis MS, Cannon J, Lewis SC (1998) Studies of acute ischemic stroke with proton magnetic resonance spectroscopy - relation between time from onset, neurological deficit, metabolite abnormalities in the infarct, blood flow, and clinical outcome. Stroke 29(8):1618\u20131624","journal-title":"Stroke"},{"key":"3063_CR34","doi-asserted-by":"publisher","first-page":"2102","DOI":"10.1007\/s00134-018-5448-6","volume":"44","author":"M Oddo","year":"2018","unstructured":"Oddo M, Sandroni C, Citerio G, Miroz J-P, Horn J, Rundgren M et al (2018) Quantitative versus standard pupillary light reflex for early prognostication in comatose cardiac arrest patients: an international prospective multicenter double-blinded study. Intensive Care Med 44:2102\u20132111","journal-title":"Intensive Care Med"},{"issue":"4","key":"3063_CR35","first-page":"895","volume":"27","author":"T Lange","year":"2006","unstructured":"Lange T, Dydak U, Roberts TP, Rowley HA, Bjeljac M, Boesiger P (2006) Pitfalls in lactate measurements at 3T. Am J Neuroradiol 27(4):895\u2013901","journal-title":"Am J Neuroradiol"}],"container-title":["Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00234-022-03063-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00234-022-03063-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00234-022-03063-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T20:06:13Z","timestamp":1674245173000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00234-022-03063-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,17]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["3063"],"URL":"https:\/\/doi.org\/10.1007\/s00234-022-03063-z","relation":{},"ISSN":["0028-3940","1432-1920"],"issn-type":[{"value":"0028-3940","type":"print"},{"value":"1432-1920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,17]]},"assertion":[{"value":"2 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the ethics committee of the Hospital District of Southwest Finland and the institutional review boards of the Helsinki University Hospital and the Finnish Medicines Agency.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All patients\u2019 next of kin or legal representative gave written informed assent within 4\u00a0h after hospital arrival. Consent was sought from patients when they regained consciousness.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"TL reports a grant from the Finnish Foundation for Cardiovascular Research. RL is a paid governmental consultant official for the National Supervisory Authority for Welfare and Health. AS reports grants from the Academy of Finland and Finnish Foundation for Cardiovascular Research during the conduct of the study; consulting fees from the GE Healthcare, Novartis, Abbot, and Astra Zeneca. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}