Quantitative EEG provides early prediction of poor outcome in acute ischemic stroke after endovascular treatment: a preliminary study

ABSTRACT

Background and Purpose: Quantitative electroencephalogram (QEEG) parameters have been previously utilized in prognosis following acute ischemic stroke (AIS). However, the use and interpretation of QEEG parameters remain scarce following endovascular treatment (EVT) of AIS.

Methods: AIS patients were prospectively enrolled following EVT, and 24-hour EEG monitoring was conducted. Global delta/alpha ratio (DAR), (delta + theta)/(alpha + beta) ratio (DTABR), and relative band power were analyzed. Primary outcome was a poor outcome (modified Rankin Scale ≥4 at 90-day follow-up). Multivariate logistic regression and diagnostic analyses were performed.

Results: Poor outcome was seen in 35.5% (11/31) of enrolled patients. Multivariable logistic regression identified that higher DAR (OR 1.10, 95% CI 1.02–1.18, p = 0.02) and higher DTABR (OR 1.13, 95% CI 1.01–1.27, p = 0.02) were associated with poor outcome. DAR ≥14.3 demonstrated high sensitivity (90.9%), specificity (90.0%) and accuracy (90.3%) for poor outcome.

Conclusions: Early evidence of elevated DAR and DTABR on quantitative EEG was associated with poor outcome at 90 days following EVT for AIS.

KEYWORDS:

• QEEG
• DAR
• DTABR
• acute ischemic stroke
• endovascular treatment
• prognosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Key R&D program of China (2016YFC1307301) and the National Natural Science Foundation of China (81820108012).

Notes on contributors

Yunfeng Wang

Yunfeng Wang is PhD student at Capital Medical University, Beijing, China.

Jingyi Liu

Jingyi Liu is PhD student at Capital Medical University, Beijing, China.

Chaohong Kong

Chaohong Kong is an attending physician at the Neurointensive Care Unit(NICU) of Renmin Hospital of Wuhan University,Wuhan, China.

Zhe Zhang

Zhe Zhang is a resident at the Neurointensive Care Unit(NICU) of Beijing Tiantan Hospital, Capital Medical University.

Wanying Duan

Wanying Duan is a resident at the Neurointensive Care Unit(NICU) of Beijing Tiantan Hospital, Capital Medical University.

David Dornbos

David Dornbos is a Neurosurgery Specialist at Semmes-Murphey Clinic, University of Tennessee Health Science Center, in Memphis, TN, USA.

Liping Liu

Liping Liu is Associate Professor at the clinical and basic research on the early management of acute stroke and neurointensive care. She is currently the director of the Neurointensive Care Unit(NICU) of Beijing Tiantan Hospital, Capital Medical University.