Early EEG Alterations Correlate with CTP Hypoperfused Volumes and Neurological Deficit: A Wireless EEG Study in Hyper-Acute Ischemic Stroke

Abstract

Brain electrical activity in acute ischemic stroke is related to the hypoperfusion of cerebral tissue as manifestation of neurovascular coupling. EEG could be applicable for bedside functional monitoring in emergency settings. We aimed to investigate the relation between hyper-acute ischemic stroke EEG changes, measured with bedside wireless-EEG, and hypoperfused core-penumbra CT-perfusion (CTP) volumes. In addition, we investigated the association of EEG and CTP parameters with neurological deficit measured by NIHSS. We analyzed and processed EEG, CTP and clinical data of 31 anterior acute ischemic stroke patients registered within 4.5 h from symptom onset. Delta/alpha ratio (DAR), (delta + theta)/(alpha + beta) ratio (DTABR) and relative delta power correlated directly (ρ = 0.72; 0.63; 0.65, respectively), while alpha correlated inversely (ρ = − 0.66) with total hypoperfused volume. DAR, DTBAR and relative delta and alpha parameters also correlated with ischemic core volume (ρ = 0.55; 0.50; 0.59; − 0.51, respectively). The same EEG parameters and CTP volumes showed significant relation with NIHSS at admission. The multivariate stepwise regression showed that DAR was the strongest predictor of NIHSS at admission (p < 0.001). The results of this study showed that hyper-acute alterations of EEG parameters are highly related to the extent of hypoperfused tissue highlighting the value of quantitative EEG as a possible complementary tool in the evaluation of stroke severity and its potential role in acute ischemic stroke monitoring.

Early Diagnosis of Acute Ischemic Stroke by Brain Computed Tomography Perfusion Imaging Combined with Head and Neck Computed Tomography Angiography on Deep Learning Algorithm

“…It is an algorithm that attempts to abstract data at a high level using multiple processing layers composed of complex structures or multiple nonlinear transformations. So far, several deep learning frameworks have been applied in the fields of computer vision, speech recognition, natural language processing, medicine, and bioinformatics [ 16 ].…”

EEG changes and motor deficits in Parkinson’s disease patients: Correlation of motor scales and EEG power bands

“…There is a growing research interest towards the neurophysiological biomarkers for monitoring the progression of neurological disability usually measured by clinical scales [9][10][11][12][13][14]. Currently, there are no reliable objective biomarkers for disease progression in PD [9].…”

“…Biomarkers ideally should be techniques that are non-invasive, widely available and economic. Electroencephalography (EEG), as a technique that combines the aforementioned aspects, provides insight into cortical function by measuring cerebral electrical activity and by quantitative analyses of the brain can provide more information about the cortical dysfunction [12,15,16].…”

Closed-Loop Transcutaneous Auricular Vagal Nerve Stimulation: Current Situation and Future Possibilities

“…In addition to epilepsy and MDD, a myriad of neurological and psychiatric disorders have event-related EEG biomarkers. Therefore, EEG-gated CL-taVNS may be extended to more brain diseases in the future, including but not limited to Alzheimer’s disease (AD; Chang et al, 2018 ; Gaubert et al, 2019 ), and ischaemic stroke (Ajčević et al, 2021 ; Dawson et al, 2021 ). A more in-depth systematic review should focus primarily on the EEG biomarkers of the taVNS-ameliorable brain diseases to explore potential therapeutic applications.…”