Hyper-acute EEG alterations predict functional and morphological outcomes in thrombolysis-treated ischemic stroke: a wireless EEG study

Abstract

Owing to the large inter-subject variability, early post-stroke prognosis is challenging, and objective biomarkers that can provide further prognostic information are still needed. The relation between quantitative EEG parameters in pre-thrombolysis hyper-acute phase and outcomes has still to be investigated. Hence, possible correlations between early EEG biomarkers, measured on bedside wireless EEG, and short-term/long-term functional and morphological outcomes were investigated in thrombolysis-treated strokes. EEG with a wireless device was performed in 20 patients with hyper-acute (< 4.5 h from onset) anterior ischemic stroke before reperfusion treatment. The correlations between outcome parameters (i.e., 7-day/12-month National Institutes of Health Stroke Scale NIHSS, 12-month modified Rankin Scale mRS, final infarct volume) and the pre-treatment EEG parameters were studied. Relative delta power and alpha power, delta/alpha (DAR), and (delta+theta)/(alpha+beta) (DTABR) ratios significantly correlated with NIHSS 7-day (rho = 0.80, − 0.81, 0.76, 0.75, respectively) and NIHSS 12-month (0.73, − 0.78, 0.74, 0.73, respectively), as well as with final infarct volume (0.75, − 0.70, 0.78, 0.62, respectively). A good outcome in terms of mRS ≤ 2 at 12 months was associated with DAR parameter (p = 0.008). The neurophysiological biomarkers obtained by non-invasive and portable technique as wireless EEG in the early pre-treatment phase may contribute as objective parameters to the short/long-term outcome prediction pivotal to better establish the treatment strategies.Graphical abstract

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

“…31 These results are in line with a previous study in which a correlation between early EEG alterations and neurological deficit at admission, as well as a correlation between EEG changes and clinical outcome were observed. 3 A recent study reported the positive correlation between CTP hypoperfused volume and NIHSS. 19 EEG alterations, especially in terms of DAR, DTBAR and relative alpha parameters extracted in sub-acute phase were related to functional outcome.…”

“…Encephalogram (EEG) could be applicable for bedside functional monitoring in emergency setting. 3 , 38 , 41 EEG is a non-invasive technique, characterized by high temporal resolution and it enables fast evaluation of instantaneous brain function. Moreover, it shows good sensitivity to acute changes in cerebral blood flow (CBF) 35 , 36 and neural metabolism.…”

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].…”

The Prognostic Utility of Electroencephalography in Stroke Recovery: A Systematic Review and Meta-Analysis

“…Two papers 33,34 that examined the same sample of subjects were treated as a single paper in the analysis. Nine papers [33][34][35][36][37][38][39][40][41] reported EEG and/or outcome measure scores at 2 or more time points. Therefore, we included data at each timepoint.…”

“…EEG was obtained for both clinical [58][59][60][61][62][63][64][65] (n = 8 papers) and research [33][34][35][36][37][38][39][40][41][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] (n = 67 papers) purposes. Of 63 papers with mean EEG time ≤2 months post-stroke, 47 papers obtained EEG during rest, 1 paper obtained EEG during upper limb movement, and 15 papers obtained EEG response to stimuli, the majority being electrical nerve stimulation in 9 papers (Figure 3).…”