{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:14:35Z","timestamp":1777299275842,"version":"3.51.4"},"reference-count":78,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":91,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01NS102574"],"award-info":[{"award-number":["R01NS102574"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5P41EB030006"],"award-info":[{"award-number":["5P41EB030006"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["19AIML35170037"],"award-info":[{"award-number":["19AIML35170037"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Massachusetts General Hospital Institute for Heart"},{"name":"Massachusetts General Hospital Executive Committee on Research"},{"DOI":"10.13039\/100011495","name":"Massachusetts Life Sciences Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011495","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Accurate neuroprognostication of cardiac arrest survivors who are initially comatose after restoration of spontaneous circulation is crucial for guiding patient management. Because hypoxic-ischaemic injury is typically diffuse, damage to a network of brain regions is likely involved in the patient\u2019s disorder of consciousness. To quantify these complex brain network changes, graph theoretical methods were applied. We hypothesize that structural connectivity metrics may provide insights into which patients will likely recover consciousness. Eighteen comatose patients (50 \u00b1 22 years, 44% male) and four healthy participants (40 \u00b1 20 years, 50% male) underwent multi-shell high angular diffusion MRI as part of a prospective study. Structural connectivity matrices were constructed using probabilistic tractography to measure the likelihood of connections between anatomical regions. Network topology alterations were quantified using clustering coefficient, global efficiency and degree. Hub index analysis was performed to explore the impact of anoxic injury on high-degree hubs. Network parameters were compared between patients with arousal recovery (AR, eye-opening to auditory or noxious stimulation) and without arousal recovery (No AR). Analyses were repeated for AR patients who achieved emergence from the minimally conscious state (EMCS) within one-year post-cardiac arrest and AR patients who did not achieve EMCS (AR\u2032). Significant differences were observed between the Controls, AR and No AR for all four metrics (Kruskal\u2013Wallis Tests, P &amp;lt; 0.05). Worsening disorders of consciousness were associated with decreasing brain complexity (Kendall's tau, P&amp;lt;0.01). Post-hoc testing showed Control values were significantly greater than No AR for all metrics (Wilcoxon rank sum, P &amp;lt; 0.05). Control values were greater than AR for all metrics (P &amp;lt; 0.05), except the clustering coefficient (P = 0.36). AR was significantly greater than No AR for all metrics (P &amp;lt; 0.05), except for the hub index (P = 0.12). Notable differences between AR\u2032 and Controls were observed for all metrics (P &amp;lt; 0.05), except clustering coefficient (P = 0.11). No significant differences were found between AR\u2032 and No AR groups. In contrast, for all metrics, EMCS values were not significantly different compared with the Controls but were significantly different than the No AR cohort values (P &amp;lt; 0.05). The hub index analysis revealed disproportionate damage to high-degree nodes such as the thalamus, putamen and precuneus, further linking topological disruption to the severity of outcomes. This study highlights the potential of graph theoretical measures of structural connectivity to guide decisions in the care of comatose cardiac arrest patients. By bridging structural connectivity with clinical outcomes, this research provides valuable insights into the neural mechanisms underlying consciousness and recovery after cardiac arrest.<\/jats:p>","DOI":"10.1093\/braincomms\/fcag117","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:44:57Z","timestamp":1775043897000},"source":"Crossref","is-referenced-by-count":1,"title":["Connectome disruptions after hypoxic-ischaemic injury associate with consciousness disorder severity"],"prefix":"10.1093","volume":"8","author":[{"given":"Sofia G","family":"Hilger","sequence":"first","affiliation":[{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School , Charlestown, MA 02129 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric S","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annelise M","family":"Kulpanowski","sequence":"additional","affiliation":[{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School , Charlestown, MA 02129 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob A","family":"Dodelson","sequence":"additional","affiliation":[{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School , Charlestown, MA 02129 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaston","family":"Cudemus-Deseda","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesiology and Critical Care Medicine, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjorie","family":"Villien","sequence":"additional","affiliation":[{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School , Charlestown, MA 02129 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7235-8456","authenticated-orcid":false,"given":"Brian L","family":"Edlow","sequence":"additional","affiliation":[{"name":"Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School , Charlestown, MA 02129 ,","place":["USA"]},{"name":"Department of Neurology, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James L","family":"Januzzi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiology Division, Massachusetts General Hospital and Baim Institute for Clinical Research , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MingMing","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W Taylor","family":"Kimberly","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edilberto","family":"Amorim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M Brandon","family":"Westover","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center , Boston, MA 02215 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A","family":"Copen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Neuroradiology Division, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela W","family":"Schaefer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Neuroradiology Division, Massachusetts General Hospital , Boston, MA 02114 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph T","family":"Giacino","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School , Charlestown, MA 02129 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M","family":"Greer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston University School of Medicine, Boston Medical Center , Boston, MA 02118 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5509-9461","authenticated-orcid":false,"given":"Ona","family":"Wu","sequence":"additional","affiliation":[{"name":"Athinoula A. 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