Application Of Quantitative Electroencephalogram In Acute Anterior Circulation Ischemic Stroke Patients With Thrombectomy

Objective:To study the application of quantitative electroencephalography(EEG)in patients with acute anterior circulation ischemic stroke.Methods:Prospective analysis of patients diagnosed with acute anterior circulation ischemic stroke and concurrent thrombectomy in the Stroke Center of the First Affiliated Hospital of Nanchang University from June 2020 to December 2020.These patients were monitored by dynamic electroencephalogram(EEG).Quantitative EEGδwave index,DAR,DTABR(DTABR=(θ+δ)/(α+β),DAR=δ/α)at 4 time periods before,12 hours after,24 hours after and 7 days after thrombectomy were calculated m RS score before thrombolectomy,NIHSS before thrombolectomy,NIHSS 24 hours after thrombolectomy and NIHSS 7 days after thrombolectomy were recorded at the same time.MRS score at 3 months after thrombolectomy was performed and divided into good prognosis group and poor prognosis group according to the m RS at 3months(m RS < 3 was classified as good prognosis group,and m RS ≥3 was classified as poor prognosis group).The correlation between quantitative EEG indexes δ、DAR and DTABR at different time periods and clinical scores at different time periods was analyzed,and the sensitivity and specificity of quantitative EEG indexes δ,DAR and DTABR at different time periods to predict the poor prognosis in three months were analyzed by receiver Operating curve(ROC),the quantitative EEG δ 、 DAR and DTABR changes before,24 hours and 7 days after thrombectomy were compared between the good group and the poor group,quantitative EEG indexes and CTP parameters were compared in the healthy and ill side.Results:1.Twenty-six patients with anterior circulation thrombectomy were included,including 12 in the group with good prognosis and 14 in the group with poor prognosis.2.Correlation analysis between quantitative EEG and clinical scores in different time periods: δ、DAR and DTABR of quantitative EEG before,12 hours,24 hours and 7 days after thrombectomy were significantly positively correlated with MRS of3 months after thrombectomy,with significant significance.Quantitative EEG δ 、DAR and DTABR before and 12 h after thrombectomy had no correlation with clinical scores within 7 days(except that DTABR 12 h after thrombectomy had a significant positive correlation with NIHSS 24 h after thrombectomy).Quantitative EEG δ、DAR and DTABR at 24 h and 7 d after thrombectomy were significantly positively correlated with clinical scores at 7 d(except that δ at 7 d after thrombectomy was not correlated with NIHSS at 7 d).3.ROC curve analysis of quantitative EEG in different time periods for predicting prognosis at 3 months: DAR at 7 days after thrombectomy had the highest predictive value for poor prognosis.4.Trend analysis of quantitative EEG δ 、 DAR and DTABR in different prognostic groups: δ 、 DAR and DTABR wave indices of the group with good prognosis all decreased 24 hours after thrombectomy,showing statistical differences in the poor prognosis group,δ,DAR and DTABR decreased 24 hours after thrombectomy,and the decrease degree was less than that in the good prognosis group,but only δ and the difference was statistically significant in the group with good prognosis,δ,DAR and DTABR increased slightly at 7 days after thrombectomy compared with 24 hours,but still decreased significantly compared with before thrombectomy,except for DAR,which was statistically significant in the poor prognosis group,δ、DAR and DTABR also increased from 24 h to 24 h,and the increase degree was greater than that in the good prognosis group.δ 、 DAR and DTABR still showed a downward trend compared with before thrombectomy,and the increase of DTABR was more than that before thrombectomy,with statistical significance except δ.5.There were differences in quantitative EEG indexes and CTP parameters between the healthy side and the affected side before thrombotomy,and the CTP parameters CBV and CBF of the healthy side were more than those of the affected side,while MTT and Tmax of the healthy side were less than those of the affected side.The quantitative EEG indexes δ index,DAR and DTABR were all higher in the affected side than in the healthy side.Conclusions:1.The larger the EEG δ,DAR,and DTABR values,the worse the prognosis of patients with acute before.2.7 days after tied DAR> 3.23 for the standard predicts 3 months after adverse reasons,there is best predictive value.3.The degree of modification of EEG δ,DAR,and DTABR values can be reacted.4.In the acute stage,quantitative EEG indicators and CTP parameters have the same effect on distinguishing the onset sites of ischemic stroke.