EEG in ischaemic stroke: Quantitative EEG can uniquely inform (sub-)acute prognoses and clinical management

Finnigan, Simon; Putten, Michel Johannes Antonius Maria van

doi:10.1016/j.clinph.2012.07.003

Cited by 246 publications

(281 citation statements)

References 63 publications

(143 reference statements)

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“…[38][39][40] A multivariate autoregressive model (MVAR) was adapted to carry out these analyses. 41 XðtÞ ¼ ½x 1 ðtÞ; x 2 ðtÞ; : : : ; x n ðtÞ T denoted the multichannel ECoG data vector, and x n ðtÞ denoted the n'th channel of ECoG signal (i.e., n ¼ 6, in this study).…”

Section: Data Analysis Of Electrophysiological Recordingsmentioning

confidence: 99%

Improving neurovascular outcomes with bilateral forepaw stimulation in a rat photothrombotic ischemic stroke model

et al. 2014

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Abstract. Restoring perfusion to the penumbra during the hyperacute phase of ischemic stroke is a key goal of neuroprotection. Thrombolysis is currently the only approved treatment for ischemic stroke. However, its use is limited by the narrow therapeutic window and side effect of bleeding. Therefore, other interventions are desired that could potentially increase the perfusion of the penumbra. Here, we hypothesized that bilateral peripheral electrical stimulation will improve cerebral perfusion and restore cortical neurovascular response. We assess the outcomes of bilateral forepaw electrical stimulation at intensities of 2 and 4 mA, administered either unilaterally or bilaterally. We developed a combined electrocorticogram (ECoG)-functional photoacoustic microscopy (fPAM) system to evaluate the relative changes in cerebral hemodynamic function and electrophysiologic response to acute, focal stroke. The fPAM system is used for cerebral blood volume (CBV) and hemoglobin oxygen saturation (SO 2 ) and the ECoG for neural activity, namely somatosensory-evoked potential (SSEP), interhemispheric coherence, and alpha-delta ratio (ADR) in response to forepaw stimulation. Our results confirmed the neuroprotective effect of bilateral forepaw stimulation at 2 mA as indicated by the 82% recovery of ADR and 95% improvement in perfusion into the region of penumbra. This experimental model can be used to study other potential interventions such as therapeutic hypertension and hypercarbia.

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Section: Data Analysis Of Electrophysiological Recordingsmentioning

confidence: 99%

Improving neurovascular outcomes with bilateral forepaw stimulation in a rat photothrombotic ischemic stroke model

et al. 2014

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“…5,6 Electrophysiological abnormalities reflecting functional changes may emerge earlier than structural changes and may better detect changes in neuronal function that precede structural changes in acute stroke 7,8 Prior electrophysiological studies were based on monitoring brain electrical activity using the 19 conventional electrode recording locations that are time-consuming and not available in most EDs, making this modality impractical for acute diagnosis and decision-making. Initial screening and triage of stroke patients in the ED would need to be done using a reduced electrode montage that could be rapidly applied, not requiring electroencephalogram (EEG) technologist participation and with rapid feedback to the clinician.…”

mentioning

confidence: 99%

Identification of Acute Stroke Using Quantified Brain Electrical Activity

Michelson

Hanley

Chabot

et al. 2015

Academic Emergency Medicine

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Objectives: Acute stroke is a leading cause of brain injury and death and requires rapid and accurate diagnosis. Noncontrast head computed tomography (CT) is the first line for diagnosis in the emergency department (ED). Complicating rapid triage are presenting conditions that clinically mimic stroke. There is an extensive literature reporting clinical utility of brain electrical activity in early diagnosis and management of acute stroke. However, existing technologies do not lend themselves to easily acquired rapid evaluation. This investigation used an independently derived classifier algorithm for the identification of traumatic structural brain injury based on brain electrical activity recorded from a reduced frontal montage to explore the potential clinical utility of such an approach in acute stroke assessment.Methods: Adult patients (age 18 to 95 years) presenting with stroke-like and/or altered mental status symptoms were recruited from urban academic EDs as part of a large research study evaluating the clinical utility of quantitative brain electrical activity in acutely brain-injured patients. All patients from the parent study who had confirmed strokes, and a control group of stroke mimics (those with final ED diagnoses of migraine or syncope), were selected for this study. All stroke patients underwent head CT scans. Some patients with negative CTs had further imaging with magnetic resonance imaging (MRI). Ten minutes of electroencephalographic data were acquired on a hand-held device in development, from five frontal electrodes. Data analyses were done offline. A Structural Brain Injury Index (SBII) was derived using an independently developed binary discriminant classification algorithm whose input was specified features of brain electrical activity. The SBII was previously found to have high accuracy in the identification of traumatic brain-injured patients who were found to have brain injury on CT (CT+). This algorithm was applied to patients in this study and used to classify patients as CT+ or not CT+. Performance was assessed using sensitivity, specificity, and negative and positive predictive values (NPV, PPV).Results: Forty-eight stroke patients (31 ischemic and 17 hemorrhagic) and 135 stroke mimic controls were included. Within the ischemic population, approximately half were CT-but later confirmed for stroke with MRI (CT-/MRI+). Sensitivity to stroke was 91.7%, specificity 50.4% (to stroke mimic), NPV 94.4%, and PPV 39.6%. Eighty percent of the CT-/MRI+ ischemic strokes were correctly identified at the time of the CT-scan.Conclusions: Despite a small population and the use of a classifier without the benefit of training on a stroke population, these data suggest that a rapidly acquired, easy-to-use system to assess brain electrical activity at the time of evaluation of acute stroke could be a valuable adjunct to current clinical practice.ACADEMIC EMERGENCY MEDICINE 2015;22:67-72

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“…These findings suggest that although delta frequency power may be associated with depression, it is also influenced by other neurological conditions such as dementia. This may also be the case in stroke patients with depression as delta frequency power is affected by stroke severity (Finnigan and van Putten, 2013a). …”

Section: Psd and Qeeg Measuresmentioning

confidence: 99%

“…It has been suggested that delta activity is associated with regional cerebral blood flow (rCBF) while preserved alpha activity is linked to neuronal function (Luu et al, 2001, Niedermeyer and Da Silva, 2005, Finnigan and van Putten, 2013a. Various reports indicate that measures of delta power relative to that of faster activity can uniquely inform IS management (Finnigan and van Putten, 2013a) and as such slow wave and fast wave indices are often analysed as power ratios (either DAR or DTABR) (Claassen et al, 2004). During acute stages of stroke such ratios are uniquely sensitive to even subtle ischaemic changes in brain function (Jordan, 2004) EEG was recorded in 35 people with a history of sub-cortical VCIND and 22 people with MCI living in the community (Sheorajpanday et al, 2014).…”

Section: Qeeg Synchronicity and Cognitive Impairmentmentioning

confidence: 99%

“…Szirmai et al (2005) used transcranial doppler sonography (TCD) and EEG to show a relationship between neuronal activity and blood flow during cognitive tasks in a healthy population (Szirmai et al, 2005). It has been suggested that delta activity is associated with regional cerebral blood flow (rCBF) while preserved alpha activity is linked to neuronal function (Luu et al, 2001, Niedermeyer and Da Silva, 2005, Finnigan and van Putten, 2013a. Various reports indicate that measures of delta power relative to that of faster activity can uniquely inform IS management (Finnigan and van Putten, 2013a) and as such slow wave and fast wave indices are often analysed as power ratios (either DAR or DTABR) (Claassen et al, 2004).…”

Section: Qeeg Synchronicity and Cognitive Impairmentmentioning

confidence: 99%

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Investigating the ability of post-stroke EEG measures of brain dysfuntion to inform early prediction of cognitive impairment or depression outcomes

Schleiger¹

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EEG in ischaemic stroke: Quantitative EEG can uniquely inform (sub-)acute prognoses and clinical management

Cited by 246 publications

References 63 publications

Improving neurovascular outcomes with bilateral forepaw stimulation in a rat photothrombotic ischemic stroke model

Improving neurovascular outcomes with bilateral forepaw stimulation in a rat photothrombotic ischemic stroke model

Identification of Acute Stroke Using Quantified Brain Electrical Activity

Investigating the ability of post-stroke EEG measures of brain dysfuntion to inform early prediction of cognitive impairment or depression outcomes

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