Electroencephalography (EEG) is immediate and sensitive to cortical impairment resulting from ischemic stroke and is considered as the potential predictive tool of stroke onset, and post-stroke clinical management. Brainwave monitoring outside the heavily equipped clinical environment demands a low-cost, portable, and wearable EEG system. This study aims to assess the feasibility of using an ambulatory EEG system to classify the stroke patient group with neurological changes due to ischemic stroke and the control healthy adult group. HealthSOS, a real-time health monitoring system for stroke prognostics, is proposed here, which consists of an eye-mask embedded portable EEG device, data analytics, and medical ontology based health advisor service. This system was investigated with 37 stroke patients (mean age 71.6 years, 61% male) admitted in the emergency unit of a hospital and 36 healthy elderly volunteers (mean age 76 years, 28% male). EEG was recorded in resting-state using the portable device with frontal cortical electrodes (Fp1, Fp2) embedded in an eye-mask within 120 h after the onset of symptoms of ischemic stroke (confirmed clinically). The EEG data acquisition of the left and right brain hemispheres was done for at least 15 minutes in the awake resting state while subjects laid down on the bed. The statistical result shows that the revised brain symmetry index (rsBSI), the delta-alpha ratio, and the delta-theta ratio of the stroke group differ significantly from those of the healthy control group. In the machine learning analysis, the support vector machine (SVM) model shows the highest accuracy (Overall accuracy: 92%) and the highest Gini coefficient (95%) in classification performance. This study will be useful for early stroke prognostics and the management of post-stroke treatment.

Electroencephalography (EEG) can access ischemic stroke-derived cortical impairment and is believed to be a prospective predictive method for acute stroke prognostics, neurological outcome, and post-stroke rehabilitation management. This study aims to quantify EEG features to understand task-induced neurological declines due to stroke and evaluate the biomarkers to distinguish the ischemic stroke group and the healthy adult group. We investigated forty-eight stroke patients (average age 72.2 years, 62% male) admitted to the rehabilitation center and seventy-five healthy adults (average age 77 years, 31% male) with no history of known neurological diseases. EEG was recorded through frontal, central, temporal, and occipital cortical electrodes (Fz, C1, C2, T7, T8, Oz) using wireless EEG devices and a newly developed data acquisition platform within three months after the appearance of symptoms of ischemic stroke (clinically confirmed). Continuous EEG data were recorded during the consecutive resting, motor (walking and working activities), and cognitive reading tasks. The statistical results showed that alpha, theta, and delta activities are biomarkers classifying the stroke patients and the healthy adults in the motor and cognitive states. DAR and DTR of the stroke group differed significantly from those of the healthy control group during the resting, motor, and cognitive tasks. Using the machine-learning approach, the C5.0 model showed 78% accuracy for the resting state, 89% accuracy in the functional motor walking condition, 84% accuracy in the working condition, and 85% accuracy in the cognitive reading state for classification the stroke group and the control group. This study is expected to be helpful for post-stroke treatment and post-stroke recovery.

Electrocardiogram (ECG) is sensitive to autonomic dysfunction and cardiac complications derived from ischemic or hemorrhage stroke and is supposed to be a potential prognostic tool in stroke identification and post-stroke treatment. ECG data generated cannot be real-time accumulated, processed, and used for enterprise-level healthcare and wellness services with the existing cardiovascular monitoring system used in hospitals. This study aims to assess the feasibility of a cyber-physical cardiac monitoring system to classify stroke patients with altered cardiac activity and healthy adults. Here, we propose Big-ECG, a cyber-physical cardiac monitoring system for stroke management, consisting of a wearable ECG sensor, data storage and data analysis in a big data platform, and health advisory services using data analytics and medical ontology. We investigated our proposed ECG-based patient monitoring system with 45 stroke patients (average age 70.8 years old, 68% men) admitted to the rehabilitation center of the hospital and 40 healthy elderly volunteers (average age 75.4 years old, 38% men). We recorded ECG at resting state using a single-channel ECG patch within three months of diagnosis of ischemic stroke (clinically confirmed). In statistical results, ECG fiducial features, RR-I, QRS, QT, ST, and heart rate variability (HRV) features, SDSD, LF/HF, LF/(LF+HF), and HF/(LF+HF) are observed as significantly distinctive biomarkers for the stroke group relative to the healthy control group. The Random Trees model presented the best classification performance (overall accuracy: 95.6%) utilizing ECG fiducial variables. This system may assist healthcare enterprises in prognosis and rehabilitation management during post-stroke treatment.INDEX TERMS Cyber-physical systems, Electrocardiography, Biomedical monitoring, Big data applications, Biomedical informatics.