Author(s):
Bentes, C ; Peralta, AR ; Viana, P ; Martins, H ; Morgado, C ; Casimiro, C ; Franco, AC ; Fonseca, AC ; Geraldes, R ; Canhão, P ; Pinho e Melo, T ; Paiva, T ; Ferro, JM
Date: 2018
Persistent ID: http://hdl.handle.net/10400.17/3535
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): Aged; Brain Ischemia; Brain Waves; Cohort Studies; Electroencephalography; Female; Humans; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Recovery of Function; Stroke; Treatment Outcome; HSJ MED
Description
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.
