Prospective analysis of quantitative EEG indices for predicting functional outcomes in acute ischemic stroke

Objective

This study aims to assess the effectiveness of quantitative electroencephalography (qEEG) in determining the prognosis of acute ischemic stroke, thus offering a scientific foundation for early prognostic evaluation.

Methods

One hundred sixty-seven patients with acute ischemic stroke were admitted to the Neurology Department of Hebei Provincial People's Hospital between May 2022 and October 2023. All patients received standard treatments, including antiplatelet aggregation and lipid-lowering therapy to stabilize plaques. EEG data, mRS scores after three months, NIHSS scores before treatment, and basic patient information were all documented. Patients with a poor prognosis (mRS > 3) and those with a good prognosis (mRS < 3) were separated into two groups. The impact of EEG parameters on stroke prognosis was assessed. These indices included relative Alpha power (RAP), relative beta power (RBP), relative Theta power (RTP), relative Delta power (RDP), (δ+θ)/(α+β) value (DTABR), δ/θ value (DTR), α/β value (ABR), δ/α value (DAR), and α/(θ+δ) value (ATDR).

Results

RAP, RTP, RDP, DTABR, DTR, ABR, DAR, and ATDR were significantly correlated with mRS scores after three months. Univariate logistic regression analysis of the groups with good and poor prognoses revealed that NIHSS scores and EEG parameters, including α %, θ %, δ %, DTABR, ABR, DAR, and ATDR, were associated with functional outcomes. Following adjustment for NIHSS scores, multivariate logistic regression identified DTABR and DAR as predictors of functional outcomes. The optimal threshold for DTABR was 0.810, yielding a sensitivity of 0.848 and specificity of 0.864, while the cutoff value for DAR was 0.665, with a sensitivity of 0.759 and specificity of 0.955, as determined by ROC curve analysis assessing the sensitivity and specificity of DTABR and DAR in forecasting poor prognosis.

Conclusion

This study confirmed that NIHSS scores are reliable indicators of stroke severity for prognosis prediction. After accounting for NIHSS scores, it was further established that EEG indices could predict functional outcomes three months post-acute ischemic stroke, with DTABR and DAR demonstrating high sensitivity and specificity.