Predicion of the functional outcome of cerebral ischemic supratentorial stroke acute period on the basis of spectral analysis of the brain bioelectrical activity

Kuznietsov, A. A.

doi:10.14739/2310-1210.2018.3.132127

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…One study found no association between EEG-recorded seizures and GOS [37]. Another eight found associations between spectral power (alpha, theta and delta) and/or spectral power ratios and poor outcome, including: more delta activity [40,[45][46][47], less alpha activity [40,[45][46][47], greater theta activity [40,[46][47][48] but also less theta activity [45], greater DTABR [14,45] and higher Brain Symmetry Index score (denoting greater asymmetry) [49]. One study stated that qEEG frequencies predicted outcome but did not provide further detail [50].…”

Section: B) Identi Cation Of Ischaemic Versus Haemorrhagic Strokementioning

confidence: 99%

Surface Electroencephalography (EEG) During the Acute Phase of Stroke to Assist With Diagnosis and Prediction of Prognosis: a Scoping Review.

Sutcliffe

Lumley

Shaw

et al. 2021

Preprint

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BackgroundStroke is a common medical emergency responsible for significant mortality and disability. Early identification improves outcomes by promoting access to time-critical treatments such as thrombectomy for large vessel occlusion (LVO), whilst accurate prognosis could inform many acute management decisions. Surface electroencephalography (EEG) shows promise for stroke identification and outcome prediction, but evaluations have varied in technology, setting, population and purpose. This scoping review aimed to summarise published literature addressing the following questions:1. Can EEG during acute clinical assessment identify:a) Stroke versus non-stroke mimic conditionsb) Ischaemic versus haemorrhagic strokec) Ischaemic stroke due to LVO. 2. Can these states be identified if EEG is applied <6hrs since onset. 3. Does EEG during acute assessment predict clinical recovery following confirmed stroke.MethodsWe performed a systematic search of five bibliographic databases ending 19/10/2020. Two reviewers assessed eligibility of articles describing diagnostic and/or prognostic EEG application <72hrs since suspected or confirmed stroke. ResultsFrom 5892 abstracts, 210 full text articles were screened and 39 retained. Studies were small and heterogeneous. Amongst 21 reports of diagnostic data, consistent associations were reported between stroke, greater delta power, reduced alpha/beta power, corresponding ratios and greater brain asymmetry. When reported, the area under the curve (AUC) was at least good (0.81–1.00). Only one study combined clinical and EEG data (AUC 0.88). There was little data found describing whether EEG could identify ischaemic versus haemorrhagic stroke. Radiological changes suggestive of LVO were also associated with increased slow and decreased fast waves. The only study with angiographic proof of LVO reported AUC 0.86 for detection <24hrs since onset. Amongst 26 reports of prognostic data, increased slow and reduced fast wave EEG changes were associated with future dependency, neurological impairment, mortality and poor cognition, but there was little evidence that EEG enhanced outcome prediction relative to clinical and/or radiological variables. Only one study focussed solely on patients <6hrs since onset, for predicting neurological prognosis post-thrombolysis.ConclusionsAlthough studies report important associations with EEG biomarkers, further technological development and adequately powered real-world studies are required before recommendations can be made regarding application during acute stroke assessment.

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Section: B) Identi Cation Of Ischaemic Versus Haemorrhagic Strokementioning

confidence: 99%

Surface Electroencephalography (EEG) During the Acute Phase of Stroke to Assist With Diagnosis and Prediction of Prognosis: a Scoping Review.

Sutcliffe

Lumley

Shaw

et al. 2021

Preprint

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“…Перспективним є викорис тання електроенцефалографічного (ЕЕГ) дослідження для оцінювання функціонального стану церебральних структур [8]. У багатьох дослідженнях останніх років переконливо доведено високу діагностичну та прогностичну цінність спектрального аналізу біоелектричної активності головного мозку у пацієнтів з гострими ураженнями головного мозку ішемічного та травматичного ґенезів [9][10][11][12]. Дослідженню ЕЕГ-паттерну у пацієнтів з геморагічним півкульовим інсультом у зіставленні з виходом гострого періоду захворювання присвячені поодинокі роботи [13,14], що обґрунтовує актуальність досліджень, спрямованих на розробку електроенцефалографічних критеріїв прогнозування летального виходу гострого періоду ССВМК.…”

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Acute spontaneous intracerebral hemorrhage lethal outcome prediction on the ground of bioelectrical brain activity spectral analysis

Kozolkіn¹,

Kuznietsov²

2020

UVP

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Aim of the study — to detect electroencephalographic criteria of unfavorable vital outcome of spontaneous supratentorial intracerebral hemorrhage (SSICH). Prospective cohort study of 156 patients (mean age 66,7 ± 0.8 years) in acute period of SSICH on the ground of conservative treatment. Diagnosis was made based on clinical neurological and visualization data. Bioelectrical brain activity was done during first 2 days of the onset. Logistic regressive analysis was used for elaboration of prognostic criteria. It was detected, that risk of lethal SSICH outcome is independently associated with the next spectral EEG‑pattern parameters: relative spectral rhythm of δ-band of intact hemisphere (odds ratio (OR) (95 % confidence interval (CI) is equal to 1.12 (1.08—1.17), p < 0.0001), frontal occipital rhythm gradient of α-band of intact hemisphere (ОR (95 % CI) = 5,96 (1.08—33.04), p = 0.0410) and interhemispheric asymmetry of absolute spectral rhythm power of β2-band (OR (95 % CI) = 0.03 (0.001—0.88), p = 0.0419). These predictors were integrated into the mathematic model for individual prognosis of SSICH lethal outcome (AUC (95 % CI) = 0.95 (0.90—0.98), p < 0.0001, predictive accuracy is equal to 89.7 %). Bilateral predominance of electroencephalographic pattern of δ-band rhythm, inversion of negative frontal occipital rhythm gradients of α-band in both hemispheres, formation of negative interhemispheric asymmetry of absolute spectral rhythm power of δ-band, α2-band in frontal region and θ-, β-bands in parietal occipital regions in first 2 days from the SSICH onset are the EEG criteria for unfavorable vital outcome of SSICH.

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“…Численними дослідженнями доведена діагностична та прогностична цінність електроенцефалографічного (ЕЕГ) дослідження в оцінці та моніторингу функціонального стану церебральних структур у пацієнтів з гострими ураженнями головного мозку різного ґенезу [5][6][7][8]. Так, досить висока чутливість ЕЕГ щодо детекції змін біоелектричної активності головного мозку, обумовлених гострою церебральною ішемією, дозволила розробити інформативні критерії прогнозування перебігу та виходу мозкового ішемічного інсульту [9]. Мілісекундна роздільна здатність, яка не доступна таким методам дослідження як позитронна емісійна томографія та функціональна магнітно-резонансна томографія, зробила можливим застосування ЕЕГ для здійснення моніторингу біоелектричної активності головного мозку підчас каротидної ендартеректомії з метою своєчасної верифікації ятрогенної церебральної ішемії [10].…”

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“…Зазначений контингент також відрізнявся більш глибоким рівнем неврологічного дефіциту, більшим обсягом осередку ураження та більш вираженим зсувом серединних структур мозку, що дозволяє розглядати наведені вище зміни ЕЕГ-патерну в якості нейрофізіологічних маркерів тяжкості ураження специфічних систем мозку супратенторіальної локалізації. Отримані дані узгоджуються з результатами інших досліджень, в яких було продемонстровано взаємозв'язок зсуву потужності спектру ЕЕГ-патерну убік повільнохвильової активності з тяжкістю ураження церебральних структур та виходом захворювання у пацієнтів з ішемічним інсультом [9,14] та гострими травматичними ураженнями головного мозку [8].…”

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Analysis of Bioelectrical Brain Activity in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage on the Ground of Conservative Therapy in Comparison with Disease Acute Period Functional Outcome

Kozyolkin¹,

Kuznietsov²

2020

Ukr. ž. med. bìol. sportu

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Despite significant advances in basic sciences and clinical neurology, acute cerebrovascular disorders continue to be a global problem in modern medicine, occupying a leading position in the structure of causes of death and disability in most countries. Hemorrhagic stroke and its most common form spontaneous supratentorial intracerebral hemorrhage is the most destructive type of cerebrovascular disorders, which is more likely to be fatal and severely disabled than ischemic stroke. The purpose of the study was to elaborate the criteria of spontaneous supratentorial intracerebral hemorrhage acute period functional outcome on the ground of analysis of bioelectrical brain activity during conservative therapy. Material and methods. We conducted a prospective cohort study of 114 patients (mean age 67.4±0.9 years) in acute period of spontaneous supratentorial intracerebral hemorrhage on the basis of conservative therapy. Clinical and neurovisual investigation helped to set the diagnosis. Bioelectrical brain activity examination was made on 1st-2nd day and 5th-6th days of the disease onset. Logistic regression and ROC-analysis were used for prognostic criteria elaboration. Results and discussion. Unfavorable functional outcome that was evaluated as modified Rankin scale score >3 on the 21st day of the disease was detected in 53 (46.5%) cases. These patients are characterized with double-side shift (with accentuation on the affected hemisphere) of spectral rhythm power towards the slow wave activity of predominantly delta band on first-second day and the following (on 5th-6th day) absolute spectral alpha rhythm power depression in intact hemisphere on 40.9% (р=0.0054). Declining of slow wave activity in intact hemisphere (ΔDAR=-51.7%, p=0.0002) was revealed in group of patients with favorable spontaneous supratentorial intracerebral hemorrhage outcome. Mathematic model for functional outcome prognosis was elaborated. It takes into consideration the values of DAR coefficient in affected hemisphere on first-second day (ОR (95% CI) = 2.03 (1.08-3.80), р=0.0276) and DAR in intact hemisphere on 5th-6th days from the onset (ОR (95% CI) = 5.84 (2.37-14.76), р=0.0001) (AUC (95% CI) = 0.97 (0.92- 0.99), р˂0.0001, prognostic accuracy = 88.6%). Conclusion. Bioelectrical brain activity reorganization on 5th-6th day from the spontaneous supratentorial intracerebral hemorrhage onset was associated with functional disease outcome. Thus, the criteria of unfavorable functional outcome are reduction of absolute spectral alpha rhythm power and ABR coefficient in intact hemisphere, while reduction of absolute spectral delta rhythm power, DTABR and DAR coefficients in intact hemisphere were associated with favorable functional outcome

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Predicion of the functional outcome of cerebral ischemic supratentorial stroke acute period on the basis of spectral analysis of the brain bioelectrical activity

Cited by 5 publications

References 19 publications

Surface Electroencephalography (EEG) During the Acute Phase of Stroke to Assist With Diagnosis and Prediction of Prognosis: a Scoping Review.

Surface Electroencephalography (EEG) During the Acute Phase of Stroke to Assist With Diagnosis and Prediction of Prognosis: a Scoping Review.

Acute spontaneous intracerebral hemorrhage lethal outcome prediction on the ground of bioelectrical brain activity spectral analysis

Analysis of Bioelectrical Brain Activity in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage on the Ground of Conservative Therapy in Comparison with Disease Acute Period Functional Outcome

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