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 Block diagram of study protocol and main findings. Assessment at admission including wireless EEG acquisition in emergency setting (< 4.5 from stroke onset), extracted EEG features before reperfusion thrombolytic treatment. The main findings in our study sample are summarized in two different exemplificative stroke patients with different pre-thrombolysis alterations of EEG parameters resulting in different final infarct volume extensions and short/long-term clinical outcomes (NIHSS, mRS).

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

Ajčević, Miloš
;
Naccarato, Marcello;Miladinović, Aleksandar;Buoite Stella, Alex;Caruso, Paola;Accardo, Agostino;Manganotti, Paolo
2021-01-01

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 Block diagram of study protocol and main findings. Assessment at admission including wireless EEG acquisition in emergency setting (< 4.5 from stroke onset), extracted EEG features before reperfusion thrombolytic treatment. The main findings in our study sample are summarized in two different exemplificative stroke patients with different pre-thrombolysis alterations of EEG parameters resulting in different final infarct volume extensions and short/long-term clinical outcomes (NIHSS, mRS).
2021
4-dic-2020
Pubblicato
https://link.springer.com/article/10.1007/s11517-020-02280-z
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11368/2976931
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