Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis

Abstract We investigated the relationship between prefrontal functional connectivity of oxyhemoglobin and outcomes in sepsis-associated encephalopathy (SAE). Additionally, we developed a prognostic method for patients with SAE. A total of 40 consecutive patients with SAE were prospectively included....

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Main Authors: Tae Jung Kim, Jae-Myoung Kim, Ji Sung Lee, Soo-Hyun Park, Jihyun Cha, Hyeon-Min Bae, Sang-Bae Ko
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-02658-9
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author Tae Jung Kim
Jae-Myoung Kim
Ji Sung Lee
Soo-Hyun Park
Jihyun Cha
Hyeon-Min Bae
Sang-Bae Ko
author_facet Tae Jung Kim
Jae-Myoung Kim
Ji Sung Lee
Soo-Hyun Park
Jihyun Cha
Hyeon-Min Bae
Sang-Bae Ko
author_sort Tae Jung Kim
collection DOAJ
description Abstract We investigated the relationship between prefrontal functional connectivity of oxyhemoglobin and outcomes in sepsis-associated encephalopathy (SAE). Additionally, we developed a prognostic method for patients with SAE. A total of 40 consecutive patients with SAE were prospectively included. Cerebral oxyhemoglobin data were obtained using functional near-infrared spectroscopy. Functional connectivity such as density was evaluated as the strength of the temporal correlation between channels based on Pearson’s correlation coefficient of oxyhemoglobin. We obtained clinical information and evaluated severity scores using Acute Physiology and Chronic Health Evaluation (APACHE) III. Outcomes were evaluated using the modified Rankin Scale (mRS) at discharge. Patients were categorized into two groups: good outcome (mRS 0–3), and poor outcome (mRS 4–6). Among the patients with SAE, 17 (42.5%) had good outcomes. Regarding connectivity analysis, density values were significantly higher in good outcome groups at all threshold values. The developed predictive method of good outcomes using the density value at a threshold of 0.6 and the APACHE III score showed very good predictive power (area under the curve 0.951 [95% confidence interval 0.893–1.00]). This method had better discrimination powers for predicting outcome than density had at 0.6 (0.716 [0.557–0.876]; P = 0.04) or the APACHE III score had alone (0.857 [0.735–0.979]; P = 0.09). A higher functional connectivity value of oxyhemoglobin in the prefrontal connectivity analysis was associated with good outcomes in SAE. Functional connectivity analysis of the prefrontal cortex and sepsis severity may help predict the prognosis in SAE patients.
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spelling doaj-art-0ecb56e4cd3d4c09bb7cca9f9823c5402025-08-20T03:48:15ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-02658-9Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysisTae Jung Kim0Jae-Myoung Kim1Ji Sung Lee2Soo-Hyun Park3Jihyun Cha4Hyeon-Min Bae5Sang-Bae Ko6Department of Neurology, Seoul National University, College of MedicineDepartment of Research and Development, Optics Brain Electronics Laboratory, OBELAB Inc.Clinical Research Center, Asan Medical CenterDepartment of Neurology, Soonchunhyang University Seoul HospitalDepartment of Research and Development, Optics Brain Electronics Laboratory, OBELAB Inc.Department of Research and Development, Optics Brain Electronics Laboratory, OBELAB Inc.Department of Neurology, Seoul National University, College of MedicineAbstract We investigated the relationship between prefrontal functional connectivity of oxyhemoglobin and outcomes in sepsis-associated encephalopathy (SAE). Additionally, we developed a prognostic method for patients with SAE. A total of 40 consecutive patients with SAE were prospectively included. Cerebral oxyhemoglobin data were obtained using functional near-infrared spectroscopy. Functional connectivity such as density was evaluated as the strength of the temporal correlation between channels based on Pearson’s correlation coefficient of oxyhemoglobin. We obtained clinical information and evaluated severity scores using Acute Physiology and Chronic Health Evaluation (APACHE) III. Outcomes were evaluated using the modified Rankin Scale (mRS) at discharge. Patients were categorized into two groups: good outcome (mRS 0–3), and poor outcome (mRS 4–6). Among the patients with SAE, 17 (42.5%) had good outcomes. Regarding connectivity analysis, density values were significantly higher in good outcome groups at all threshold values. The developed predictive method of good outcomes using the density value at a threshold of 0.6 and the APACHE III score showed very good predictive power (area under the curve 0.951 [95% confidence interval 0.893–1.00]). This method had better discrimination powers for predicting outcome than density had at 0.6 (0.716 [0.557–0.876]; P = 0.04) or the APACHE III score had alone (0.857 [0.735–0.979]; P = 0.09). A higher functional connectivity value of oxyhemoglobin in the prefrontal connectivity analysis was associated with good outcomes in SAE. Functional connectivity analysis of the prefrontal cortex and sepsis severity may help predict the prognosis in SAE patients.https://doi.org/10.1038/s41598-025-02658-9SepsisSepsis-associated encephalopathyPatient outcome assessmentAPACHESpectroscopyNear-infrared
spellingShingle Tae Jung Kim
Jae-Myoung Kim
Ji Sung Lee
Soo-Hyun Park
Jihyun Cha
Hyeon-Min Bae
Sang-Bae Ko
Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis
Scientific Reports
Sepsis
Sepsis-associated encephalopathy
Patient outcome assessment
APACHE
Spectroscopy
Near-infrared
title Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis
title_full Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis
title_fullStr Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis
title_full_unstemmed Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis
title_short Predicting outcomes in patients with sepsis-associated encephalopathy using prefrontal functional connectivity analysis
title_sort predicting outcomes in patients with sepsis associated encephalopathy using prefrontal functional connectivity analysis
topic Sepsis
Sepsis-associated encephalopathy
Patient outcome assessment
APACHE
Spectroscopy
Near-infrared
url https://doi.org/10.1038/s41598-025-02658-9
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