Quantitative EEG and functional outcome following acute ischemic stroke

Publication date: August 2018

Source: Clinical Neurophysiology, Volume 129, Issue 8

Author(s): Carla Bentes, Ana Rita Peralta, Pedro Viana, Hugo Martins, Carlos Morgado, Carlos Casimiro, Ana Catarina Franco, Ana Catarina Fonseca, Ruth Geraldes, Patrícia Canhão, Teresa Pinho e Melo, Teresa Paiva, José M. Ferro

Abstract

Objective

To identify the most accurate quantitative electroencephalographic (qEEG) predictor(s) of unfavorable post-ischemic stroke outcome, and its discriminative capacity compared to already known demographic, clinical and imaging prognostic markers.

Methods

Prospective cohort of 151 consecutive anterior circulation ischemic stroke patients followed for 12 months. EEG was recorded within 72 h and at discharge or 7 days post-stroke. QEEG (global band power, symmetry, affected/unaffected hemisphere and time changes) indices were calculated from mean Fast Fourier Transform and analyzed as predictors of unfavorable outcome (mRS ≥ 3), at discharge and 12 months poststroke, before and after adjustment for age, admission NIHSS and ASPECTS.

Results

Higher delta, lower alpha and beta relative powers (RP) predicted outcome. Indices with higher discriminative capacity were delta-theta to alpha-beta ratio (DTABR) and alpha RP. Outcome models including either of these and other clinical/imaging stroke outcome predictors were superior to models without qEEG data. In models with qEEG indices, infarct size was not a significant outcome predictor.

Conclusions

DTAABR and alpha RP are the best qEEG indices and superior to ASPECTS in post-stroke outcome prediction. They improve the discriminative capacity of already known clinical and imaging stroke outcome predictors, both at discharge and 12 months after stroke.

Significance

qEEG indices are independent predictors of stroke outcome.

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