Early restitution of electrocorticogram predicts subsequent behavioral recovery from cardiac arrest

Previous studies have shown that parameters of EEG restitution reflect the severity of global hypoxic-ischemic brain injury. Here, the hypothesis is tested that patterns of EEG restitution during the first 4 hours predict later behavioral recovery. Time course and correlations between behavior, electrocorticogram (EcoG), and neuronal injury were investigated in a rodent model of asphyctic cardiac arrest. Forty Wistar rats were subjected to 5 minutes of asphyxia and cardiopulmonary resuscitation. Behavior was assessed by repeated scoring of neurodeficits and open field activity until euthanasia at 48 hours. Electrocorticographic bursting occurred at 13.2 ± 4 minutes after resuscitation. Bursts increased in frequency and duration until the EcoG reverted to a continuous signal. The resuscitation-continuous EcoG interval correlated with the first appearance of spontaneous movements (r = 0.80, P < 0.05). Larger intervals were associated with hyperactivity in the open field at 24 hours (r = 0.61, P < 0.05), indicating a more severe behavioral deficit. Larger intervals were also associated with worse 48-hour neurodeficit scores (P < 0.05). Neuronal damage in the hippocampus correlated with the degree of open field hyperactivity at 14 hours (P < 0.05). These findings demonstrate a close temporal and prognostic relationship between electrical and behavioral recovery after hypoxic-ischemic brain injury.