Abstract
The accurate identification and prediction of cerebral infarct evolution and clinical outcome are of paramount importance in acute ischemic stroke management. Neuroimaging in acute stroke is mandatory to establish the feasibility of reperfusion therapy, but it is not practical to assess the continuous evolution of brain ischemia. EEG could be an applicable instrument to perform functional monitoring in the hyper-acute phase. EEG activity during ischemic stroke has been widely studied in sub-acute and post-acute phase of ischemic stroke. However, only few studies have focused on the early phase of brain ischemia. The aim of this study conducted at the stroke unit was to investigate stroke-related EEG changes during the earliest phase of ischemic stroke within 4.5 h from symptom onset and to correlate these data with neurological deficit in terms of NIHSS score. We studied 12 patients with ischemic stroke, who underwent EEG recordings within 4.5 h from symptom onset. The EEG signals acquisition was performed bedside without delaying reperfusion treatment, using @64 channels Wi-Fi Be Plus LTM amplifier and 19 channel 10–20 Ag/AgCl electrodes wireless prewired headset. The main finding of this study is a significant positive correlation between stroke-related EEG changes measured by DAR and DTABR parameters and the neurological deficit measured by NIHSS score, during the earliest phase of ischemic stroke. The results of this study highlight the importance of EEG as complementary tool in the assessment of stroke severity and its potential role in acute decision-making and monitoring.
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References
The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group: Tissue plasminogen activator for acute ischemic stroke. N. Engl. J. Med. 333, 1581–1587 (1995)
Finnigan, S.P., Rose, S.E., Walsh, M., Griffin, M., Janke, A.L., McMahon, K.L., Brown, J.: Correlation of quantitative EEG in acute ischemic stroke with 30-day NIHSS score: comparison with diffusion and perfusion MRI. Stroke 35(4), 899–903 (2004)
Lewandowski, C.A., Libman, R.: Acute presentation of stroke. J. Stroke Cerebrovasc. Dis. 8(3), 117–126 (1999)
Peisker, T., Koznar, B., Stetkarova, I., et al.: Acute stroke therapy: a review. Trends Cardiovasc. Med. 27, 59–66 (2017)
Gonzalez, R.G.: Imaging-guided acute ischemic stroke therapy: from “time is brain” to “physiology is brain”. AJNR Am. J. Neuroradiol. 27(4), 728–735 (2006)
Nogueira, R.G., Jadhav, A.P., Haussen, D.C., DAWN Trial Investigators, et al.: Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N. Engl. J. Med. 378, 11–21 (2018)
Caruso, P., Naccarato, M., Furlanis, G., Ajčević, M., Stragapede, L., Ridolfi, M., Manganotti, P.: Wake-up stroke and CT perfusion: effectiveness and safety of reperfusion therapy. Neurol. Sci. 39(10), 1705–1712 (2018)
Tong, D.C., Yenari, M.A., Albers, G.W., O’Brien, M., Marks, M.P., Mosley, M.E.: Correlation of perfusion- and diffusion-weighted MRI with NIHSS score in acute (6.5 hour) ischemic stroke. Neurology 50, 864–870 (1998)
Furlanis, G., Ajčević, M., Stragapede, L., Lugnan, C., Ridolfi, M., Caruso, P., Manganotti, P.: Ischemic volume and neurological deficit: correlation of computed tomography perfusion with the National Institutes of Health Stroke Scale Score in acute ischemic stroke. J. Stroke Cerebrovasc. Dis. 27(8), 2200–2207 (2018)
Adams Jr., H.P., Davis, P.H., Leira, E.C., et al.: Baseline NIH stroke scale score strongly predicts outcome after stroke: a report of the trial of org 10172 in acute stroke treatment (TOAST). Neurology 53, 126–131 (1999)
Frankel, M.R., Morgenstern, L.B., Kwiatkowski, T., et al.: Predicting prognosis after stroke: a placebo group analysis from the National Institute of Neurological Disorders and Stroke rt-PA Stroke Trial. Neurology 55, 952–959 (2000)
Debner, S., Minow, F., Emkes, R., et al.: How about taking a low-cost, small, and wireless EEG for a walk? Psycopathology 49(11), 1617–1621 (2012)
Hairston, W.D., Whitaker, K.W., Ries, A.J., Vettel, J.M., Bradford, C.J.J., Kerick, S.E., et al.: Usability of four commercially-oriented EEG systems. J. Neural Eng. 11(4), 046018 (2014)
Finnigan, S.P., Walsh, M., Rose, S.E., Chalk, J.B.: Quantitative EEG indices of sub-acute ischaemic stroke correlate with clinical outcomes. Clin. Neurophysiol. 118(11), 2525–2532 (2007)
Sheorajpanday, R.V., Nagels, G., Weeren, A.J., van Putten, M.J., De Deyn, P.P.: Quantitative EEG in ischemic stroke: correlation with functional status after 6 months. Clin. Neurophysiol. 122(5), 874–883 (2011)
Finnigan, S., Wong, A., Read, S.: Defining abnormal slow EEG activity in acute ischaemic stroke: Delta/alpha ratio as an optimal QEEG index. Clin. Neurophysiol. 127(2), 1452–1459 (2016)
Finnigan, S., van Putten, M.J.: EEG in ischaemic stroke: quantitative EEG can uniquely inform (sub-) acute prognoses and clinical management. Clin. Neurophysiol. 124(1), 10–19 (2013)
Jordan, K.G.: Emergency EEG and continuous EEG monitoring in acute ischemic stroke. J. Clin. Neurophysiol. 21, 341–352 (2004)
Welch, P.: The use of fast fourier transform for the estimation of power spectra: a method based on time averaging over short, modified periodograms. IEEE Trans. Audio Electroacoust. 15(2), 70–73 (1967)
Niedermeyer, E.: Cerebrovascular disorders and EEG. In: Niedermeyer, E., Lopes da Silva, F. (eds.) Electroencephalography: Basic Principles Clinical Applications and Related Fields, 3rd edn, pp. 339–362. Williams & Wilkins, Philadelphia (2005)
Murri, L., Gori, S., Massetani, R., et al.: Evaluation of acute ischemic stroke using quantitative EEG: a comparison with conventional EEG and CT scan. Neurophysiol. Clin. 28, 249–257 (1998)
Acknowledgements
M. Ajčević is supported by AIRAlzh Onlus - (ANCC-COOP). The authors would like to thank Matteo di Franza for editorial assistance. This study was partially supported by Master in Clinical Engineering, University of Trieste.
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Ajčević, M. et al. (2020). Brain Oscillatory Activity and Neurological Deficit in Hyper-acute Ischemic Stroke: Correlation of EEG Changes with NIHSS. In: Henriques, J., Neves, N., de Carvalho, P. (eds) XV Mediterranean Conference on Medical and Biological Engineering and Computing – MEDICON 2019. MEDICON 2019. IFMBE Proceedings, vol 76. Springer, Cham. https://doi.org/10.1007/978-3-030-31635-8_16
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DOI: https://doi.org/10.1007/978-3-030-31635-8_16
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