Featured Publications
Quantitative epileptiform burden and electroencephalography background features predict post-traumatic epilepsy
Chen Y, Li S, Ge W, Jing J, Chen HY, Doherty D, Herman A, Kaleem S, Ding K, Osman G, Swisher CB, Smith C, Maciel CB, Alkhachroum A, Lee JW, Dhakar MB, Gilmore EJ, Sivaraju A, Hirsch LJ, Omay SB, Blumenfeld H, Sheth KN, Struck AF, Edlow BL, Westover MB, Kim JA. Quantitative epileptiform burden and electroencephalography background features predict post-traumatic epilepsy. Journal Of Neurology Neurosurgery & Psychiatry 2022, 94: 245-249. PMID: 36241423, PMCID: PMC9931627, DOI: 10.1136/jnnp-2022-329542.Peer-Reviewed Original ResearchConceptsPost-traumatic epilepsyTraumatic brain injuryCT abnormalitiesElectroencephalography featuresAdmission Glasgow Coma Scale scoreGlasgow Coma Scale scoreRetrospective case-control studyMultivariable logistic regression analysisRisk stratification modelCase-control studyLogistic regression analysisTBI admissionsSevere complicationsFuture trialsBrain injuryCT reportsSeizure diagnosisPredictive valueScale scorePatientsLogistic regressionStratification modelQuantitative electroencephalogramTBI mechanismsRegression analysisAutomated EEG-based prediction of delayed cerebral ischemia after subarachnoid hemorrhage
Zheng WL, Kim JA, Elmer J, Zafar SF, Ghanta M, Moura V, Patel A, Rosenthal E, Westover M. Automated EEG-based prediction of delayed cerebral ischemia after subarachnoid hemorrhage. Clinical Neurophysiology 2022, 143: 97-106. PMID: 36182752, PMCID: PMC9847346, DOI: 10.1016/j.clinph.2022.08.023.Peer-Reviewed Original ResearchConceptsMultiple EEG featuresEEG featuresInformative featuresPrediction algorithmSubarachnoid hemorrhageBetter performanceNon-DCI patientsMachineCerebral ischemiaDCI riskAlpha-delta ratioAneurysmal subarachnoid hemorrhageUtility of electroencephalographyReceiver operator curveFeaturesDCI predictionAlgorithmDCI onsetSAH patientsShannon entropyDay 5Whole brainAlpha variabilityPatientsPredictionHospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions
Kuohn LR, Herman AL, Soto AL, Brown SC, Gilmore EJ, Hirsch LJ, Matouk CC, Sheth KN, Kim JA. Hospital Revisits for Post-Ischemic Stroke Epilepsy after Acute Stroke Interventions. Journal Of Stroke And Cerebrovascular Diseases 2021, 31: 106155. PMID: 34688213, PMCID: PMC8766898, DOI: 10.1016/j.jstrokecerebrovasdis.2021.106155.Peer-Reviewed Original ResearchConceptsIschemic stroke survivorsIV-tPADecompressive craniectomyHospital revisitsStroke survivorsAcute stroke interventionAcute ischemic strokeAcute stroke careProportional hazards regressionImpact of therapyHistory of epilepsyAcute seizuresHospital seizuresIschemic strokeStroke severityPrimary outcomeStroke interventionStroke treatmentStroke careHazards regressionMultivariable modelRetrospective analysisCumulative rateClaims dataPatientsFocused Management of Patients With Severe Acute Brain Injury and ARDS
Kim JA, Wahlster S, LaBuzetta JN, Nobleza COS, Johnson NJ, Rubinos C, Malaiyandi D, O'Phelan KH, Mainali S, Sarwal A, Gilmore EJ. Focused Management of Patients With Severe Acute Brain Injury and ARDS. CHEST Journal 2021, 161: 140-151. PMID: 34506794, PMCID: PMC8423666, DOI: 10.1016/j.chest.2021.08.066.Peer-Reviewed Original ResearchConceptsSevere acute brain injuryAcute brain injuryBrain injuryTreatment strategiesHigh-acuity patient populationMainstay of treatmentHypothetical case scenariosSevere ARDSConcurrent diseasesPatient populationTreatment decisionsARDSConcomitant managementLung physiologyTreatment conceptNarrative reviewConcomitant occurrenceSimultaneous managementPatientsCOVID-19 pandemicInjuryNoninvasive monitoringFocused managementPhysiological basisManagementHigh epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage
Kim JA, Zheng WL, Elmer J, Jing J, Zafar SF, Ghanta M, Moura V, Gilmore EJ, Hirsch LJ, Patel A, Rosenthal E, Westover MB. High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage. Clinical Neurophysiology 2021, 141: 139-146. PMID: 33812771, PMCID: PMC8429508, DOI: 10.1016/j.clinph.2021.01.022.Peer-Reviewed Original ResearchConceptsED burdenSubarachnoid hemorrhageEpileptiform dischargesCerebral ischemiaSAH patientsHigh riskOnset of DCIMajor risk periodContinuous EEG recordingsDCI patientsDCI riskRetrospective analysisNovel biomarkersGroup-based trajectory analysisRisk periodPatientsDay 3.5DCIBurdenHemorrhageIschemiaRiskEEG recordingsBurden rateUseful parameter
2022
Epileptiform activity predicts epileptogenesis in cerebral hemorrhage
Kong THJ, Azeem M, Naeem A, Allen S, Kim JA, Struck AF. Epileptiform activity predicts epileptogenesis in cerebral hemorrhage. Annals Of Clinical And Translational Neurology 2022, 9: 1475-1480. PMID: 36030385, PMCID: PMC9463945, DOI: 10.1002/acn3.51637.Peer-Reviewed Original ResearchConceptsEpileptiform activitySubarachnoid hemorrhageRisk factorsRetrospective case-control studyNontraumatic intraparenchymal hemorrhagesDevelopment of epilepsyCase-control studyS scoresClinical seizuresAcute phaseCerebral hemorrhageIntraparenchymal hemorrhageHemorrhageSeizuresEpilepsyScoresEpileptogenesisPatientsActivityIntraparenchymalBedside monitoring of hypoxic ischemic brain injury using low-field, portable brain magnetic resonance imaging after cardiac arrest
Beekman R, Crawford A, Mazurek MH, Prabhat AM, Chavva IR, Parasuram N, Kim N, Kim JA, Petersen N, de Havenon A, Khosla A, Honiden S, Miller PE, Wira C, Daley J, Payabvash S, Greer DM, Gilmore EJ, Kimberly W, Sheth KN. Bedside monitoring of hypoxic ischemic brain injury using low-field, portable brain magnetic resonance imaging after cardiac arrest. Resuscitation 2022, 176: 150-158. PMID: 35562094, PMCID: PMC9746653, DOI: 10.1016/j.resuscitation.2022.05.002.Peer-Reviewed Original ResearchConceptsCardiac arrestBrain injuryHypoxic-ischemic brain injuryAdverse neurological outcomesIschemic brain injurySingle-center studyBrain magnetic resonanceBrain injury severityBoard-certified neuroradiologistsLow-field MRIFLAIR signal intensityNeurological outcomeCA patientsIll patientsMRI findingsCA survivorsCenter studyMRI examinationsClinical careHigh riskInjury severityPatientsSignal intensityBedside monitoringMR imagingPortable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke
Yuen MM, Prabhat AM, Mazurek MH, Chavva IR, Crawford A, Cahn BA, Beekman R, Kim JA, Gobeske KT, Petersen NH, Falcone GJ, Gilmore EJ, Hwang DY, Jasne AS, Amin H, Sharma R, Matouk C, Ward A, Schindler J, Sansing L, de Havenon A, Aydin A, Wira C, Sze G, Rosen MS, Kimberly WT, Sheth KN. Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke. Science Advances 2022, 8: eabm3952. PMID: 35442729, PMCID: PMC9020661, DOI: 10.1126/sciadv.abm3952.Peer-Reviewed Original ResearchIschemic strokeMagnetic resonance imagingResonance imagingFluid-attenuated inversion recoveryDiffusion-weighted imaging sequencesStroke volume measurementsStroke pathwayStroke severityFunctional outcomeLow-field magnetic resonance imagingBedside evaluationClinical managementStroke volumeMRI studiesStrokePatientsBrain imagingCerebellar structuresHigh-field MRI studiesHyperintense regionsInversion recoveryInfarctsUseful imagingVolume measurementsImpact of Frailty on Morbidity and Mortality in Adult Patients Undergoing Surgical Evacuation of Acute Traumatic Subdural Hematoma
Elsamadicy AA, Sandhu MRS, Freedman IG, Koo AB, Reeves BC, Yu J, Hengartner A, Havlik J, Hong CS, Rutherford HJV, Kim JA, Gerrard J, Gilmore EJ, Omay SB. Impact of Frailty on Morbidity and Mortality in Adult Patients Undergoing Surgical Evacuation of Acute Traumatic Subdural Hematoma. World Neurosurgery 2022, 162: e251-e263. PMID: 35276399, DOI: 10.1016/j.wneu.2022.02.122.Peer-Reviewed Original ResearchConceptsAcute traumatic subdural hematomaTraumatic subdural hematomaHospital mortalityNonroutine dischargeSubdural hematomaExtended LOSIndependent predictorsAdult patientsBaseline frailtyMultivariate logistic regression analysisExtended hospital lengthImpact of frailtyRetrospective cohort studyNational Trauma DatabaseLogistic regression analysisRegression analysisMultivariate regression analysisHealth care expendituresFrail patientsHospital lengthCohort studySurgical evacuationFrailty indexTrauma databasePatientsBedside detection of intracranial midline shift using portable magnetic resonance imaging
Sheth KN, Yuen MM, Mazurek MH, Cahn BA, Prabhat AM, Salehi S, Shah JT, By S, Welch EB, Sofka M, Sacolick LI, Kim JA, Payabvash S, Falcone GJ, Gilmore EJ, Hwang DY, Matouk C, Gordon-Kundu B, RN AW, Petersen N, Schindler J, Gobeske KT, Sansing LH, Sze G, Rosen MS, Kimberly WT, Kundu P. Bedside detection of intracranial midline shift using portable magnetic resonance imaging. Scientific Reports 2022, 12: 67. PMID: 34996970, PMCID: PMC8742125, DOI: 10.1038/s41598-021-03892-7.Peer-Reviewed Original ResearchConceptsMidline shiftNeuroscience intensive care unitCare measurementYale-New Haven HospitalValuable bedside toolIntensive care unitPoor clinical outcomeBrain-injured patientsMass effectNew Haven HospitalMagnetic resonance imagingClinical outcomesIll patientsCare unitStroke patientsFunctional outcomeBedside toolObservational studyBedside detectionImaging examsPatientsResonance imagingPortable MRIImaging suiteSignificant concordance
2021
A model of metabolic supply-demand mismatch leading to secondary brain injury
Song JL, Kim JA, Struck AF, Zhang R, Westover MB. A model of metabolic supply-demand mismatch leading to secondary brain injury. Journal Of Neurophysiology 2021, 126: 653-667. PMID: 34232754, PMCID: PMC8815783, DOI: 10.1152/jn.00674.2020.Peer-Reviewed Original ResearchConceptsPrimary brain injurySecondary brain injuryAcute brain injuryBrain injuryExtracellular potassiumAdditional brain injuryAssociation of seizuresIschemic strokeNeurologic insultPreventable complicationsSeizure activityCommon sequalaeTissue hypoxiaMetabolic crisisSeizuresInjuryExcitotoxicityPatientsCommon associationAssociationCurrent practiceExcitotoxityComplicationsHemorrhageIschemiaLow-Field, Portable Magnetic Resonance Imaging at the Bedside to Assess Brain Injury in Patients with Severe COVID-19 (1349)
Mazurek M, Yuen M, Cahn B, Rosen M, Gobeske K, Gilmore E, Hwang D, Kaddouh F, Kim J, Falcone G, Petersen N, Siner J, Spudich S, Sze G, Kimberly W, Sheth K. Low-Field, Portable Magnetic Resonance Imaging at the Bedside to Assess Brain Injury in Patients with Severe COVID-19 (1349). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.1349.Peer-Reviewed Original ResearchVessel wall MRI in ruptured cranial dural arteriovenous fistulas
Cord BJ, Renedo D, Santarosa C, Sujijantarat N, Antonios J, Kim JA, Falcone GJ, Sheth KN, Malhotra A, Matouk CC. Vessel wall MRI in ruptured cranial dural arteriovenous fistulas. Interventional Neuroradiology 2021, 27: 553-557. PMID: 33430655, PMCID: PMC8580544, DOI: 10.1177/1591019920988205.Peer-Reviewed Original ResearchConceptsCranial dural arteriovenous fistulasDural arteriovenous fistulaVessel wall MRIArteriovenous fistulaVW-MRIWall enhancementHigh-resolution vessel wall MRIBrain vascular malformationsTime three patientsSpontaneous subarachnoid hemorrhageMultiple intracranial aneurysmsVessel wall enhancementThree patientsVenous ectasiaMacrovascular lesionsSubarachnoid hemorrhageCase reportVascular malformationsBlood productsPreliminary experienceIntracranial aneurysmsFistulaPatientsPresumed siteMRI
2020
Deep active learning for Interictal Ictal Injury Continuum EEG patterns
Ge W, Jing J, An S, Herlopian A, Ng M, Struck AF, Appavu B, Johnson EL, Osman G, Haider HA, Karakis I, Kim JA, Halford JJ, Dhakar MB, Sarkis RA, Swisher CB, Schmitt S, Lee JW, Tabaeizadeh M, Rodriguez A, Gaspard N, Gilmore E, Herman ST, Kaplan PW, Pathmanathan J, Hong S, Rosenthal ES, Zafar S, Sun J, Westover M. Deep active learning for Interictal Ictal Injury Continuum EEG patterns. Journal Of Neuroscience Methods 2020, 351: 108966. PMID: 33131680, PMCID: PMC8135050, DOI: 10.1016/j.jneumeth.2020.108966.Peer-Reviewed Original ResearchConceptsConvolutional neural networkIll patientsActive learningLarge labeled datasetExpert-level performanceDeep active learningLarge EEG datasetsPseudo-labeled dataUse of ALElectroencephalography patternsPatient careQuery criteriaLabeled datasetLabel spreadingEEG patternsPatientsExpert labelsClass balancingNeural networkAvailable labelsVector representationQueriesInformative examplesAL approachEEG dataset
2018
Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage
Zafar SF, Postma EN, Biswal S, Boyle EJ, Bechek S, O'Connor K, Shenoy A, Kim J, Shafi MS, Patel AB, Rosenthal ES, Westover MB. Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage. Clinical Neurophysiology 2018, 129: 2219-2227. PMID: 30212805, PMCID: PMC6478499, DOI: 10.1016/j.clinph.2018.08.015.Peer-Reviewed Original ResearchConceptsAnti-epileptic drugsAneurysmal subarachnoid hemorrhageEpileptiform abnormalitiesWorse outcomesSubarachnoid hemorrhageHigh-grade aSAH patientsEvidence-based treatment protocolsGlasgow Outcome ScoreAntiepileptic drug managementStandard prophylaxisNeurologic outcomeProphylactic protocolASAH patientsOutcome scoresDrug managementHigh burdenRetrospective analysisTreatment protocolOutcome measuresPatientsDaily burdenRhythmic activityFirst dayOutcomesBurdenEpileptiform activity in traumatic brain injury predicts post‐traumatic epilepsy
Kim JA, Boyle EJ, Wu AC, Cole AJ, Staley KJ, Zafar S, Cash SS, Westover MB. Epileptiform activity in traumatic brain injury predicts post‐traumatic epilepsy. Annals Of Neurology 2018, 83: 858-862. PMID: 29537656, PMCID: PMC5912971, DOI: 10.1002/ana.25211.Peer-Reviewed Original Research
2017
Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage
Kim JA, Rosenthal ES, Biswal S, Zafar S, Shenoy AV, O'Connor KL, Bechek SC, Moura J, Shafi MM, Patel AB, Cash SS, Westover MB. Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage. Clinical Neurophysiology 2017, 128: 1091-1099. PMID: 28258936, PMCID: PMC5476529, DOI: 10.1016/j.clinph.2017.01.016.Peer-Reviewed Original ResearchConceptsCerebral ischemiaSubarachnoid hemorrhageRisk of DCISecondary cerebral injuryRhythmic delta activityAbnormal neural activityNew potential targetsCerebral injuryEarly patientsEpileptiform abnormalitiesMedical recordsEpileptiform dischargesRetrospective analysisHigh riskDCI developmentDelta activityPatientsNovel markerIschemiaSurvival analysis methodsCumulative probabilityPotential targetNeural activityNew markersDCI