The Preliminary Study Of Evaluating The Severity And Prognosis Of Ischemic Stroke Patients With Quantitative EEG

Objectives:To investigate the value of quantitative electroencephalography(qEEG)parameters in estimating severity and predicting prognosis of ischemic stroke patients.Methods:64 patients with ischemic stroke were recruited in this study.Collecting clinical data: National Institutes of Health Stroke Scale(NIHSS)score and Glasgow coma scale(GCS)score on admission,ischemic lesion location in brain and the incidence of post-stroke epilepsy.Patients with modified Rankin Score(mRS)< 3 after 3 months were classified as good prognosis group,patients whose mRS ≥ 3 were classified as bad prognosis group.All patients accepted quantitative electroencephalography monitoring,then we conducted power spectrum analysis.Correlation analysis was conducted between qEEG parameters,including α index,θ index,δ index,slow wave index and alpha/theta ratio(ATR),alpha/(theta + delta)ratio(ADTR),alpha index ipsilesional hemisphere/contralesional hemisphere(α I/C),(theta + delta)index ipsilesional hemisphere/contralesional hemisphere((θ+δ)I/C),brain symmetrical index(BSI),and clinical scales.Receiver operating characteristic curve were drawn to explore the sensitivity and specificity of qEEG parameters predicting bad prognosis.Results:1.64 patients were recruited in this study,including 38 males and 26 females,11 patients were classified as good prognosis and 53 patients were classified as bad prognosis.2.Correlation analysis between qEEG parameters and NIHSS score,GCS score on admission and mRS after 3 months: NIHSS score was significantly positive correlated with δ index and slow wave index,it was also significantly negative correlated with ATR,ADTR and θ index.GCS score was significantly positive correlated with ATR and ADTR.MRS after three months was significantly positive correlated with δ index,it was also significantly negative correlated with ATR,ADTR and θ index.3.In patients with unilateral cortical ischemic lesion,NIHSS score on admission and mRS after three months were significantly negative correlated with α I/C、(θ+δ)I/C.GCS score was significantly positive correlated with(θ+δ)I/C.4.QEEG parameters predicting bad prognosis: Among all parameters,BSI was the best predictor of bad prognosis.In patients with unilateral cortical ischemic lesion,α I/C was the best predictor of bad prognosis.Conclusion:1.QEEG parameters,especially ADTR,can estimate the severity of stroke and predict the prognosis.Smaller ADTR reveals more serious neurologic impairment and worse prognosis.2.Lower α I/C、(θ+δ)I/C indicates more serious neurologic impairment and worse prognosis,which is more significant in patients whose ischemic lesions locate in unilateral cortex.3.Based on the standard of BSI>0.150,relatively high sensitivity and specificity can be acquired in predicting bad prognosis.In patients with unilateral cortical ischemic lesion,α I/C<0.947 can be a better predictor of bad prognosis.