Contralateral hemisphere delta EEG in acute stroke precedes worsening of symptoms and death

Finnigan, S. P., Rose, Stephen E. and Chalk, Jonathan B. (2008) Contralateral hemisphere delta EEG in acute stroke precedes worsening of symptoms and death. Clinical Neurophysiology, 119 7: 1690-1694. doi:10.1016/j.clinph.2008.03.006

Author Finnigan, S. P.
Rose, Stephen E.
Chalk, Jonathan B.
Title Contralateral hemisphere delta EEG in acute stroke precedes worsening of symptoms and death
Journal name Clinical Neurophysiology   Check publisher's open access policy
ISSN 1388-2457
Publication date 2008-07
Sub-type Letter to editor, brief commentary or brief communication
DOI 10.1016/j.clinph.2008.03.006
Volume 119
Issue 7
Start page 1690
End page 1694
Total pages 5
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Language eng
Subject 1109 Neurosciences
1702 Cognitive Sciences
1103 Clinical Sciences
Formatted abstract
A number of recent studies report that quantitative electroencephalography (QEEG) measures of cerebral pathophysiology in acute or sub-acute stroke might augment future prognoses regarding patient outcomes (e.g., Claassen et al., 2004; Cuspineda et al., 2003; Finnigan et al., 2004, 2006, 2007; Jordan, 2004; Tecchio et al., 2007; van Putten and Tavy, 2004; Zappasodi et al., 2007). For example we have reported that QEEG delta (~1 to 4 Hz) power measures in acute stroke (Finnigan et al., 2004, 2006) and delta/alpha power ratio (DAR) measures in sub-acute stroke (Finnigan et al., 2007) are both highly correlated with ischaemic stroke patients’ outcomes assessed via the National Institutes of Health Stroke Scale (NIHSS). QEEG measures were averaged over all scalp electrodes and further a significant correlation between subacute DAR and outcome measures was obtained when the former was computed from a standard, 19-electrode array.Some QEEG measures incorporate separate computations for each cerebral hemisphere (e.g. van Putten and Tavy, 2004); Tecchio et al. (2007) acquired hemisphere-specific magnetoencephalography (MEG) data from subacute ischaemic stroke patients and reported that delta measures from the contralateral hemisphere (CH) appear valuable in predicting clinical outcome assessed via NIHSS at followup (median 7.8 months post-stroke). Moreover, multinomial logistic regression analyses revealed that this QEEG measure per se enhanced the sensitivity and specificity of outcome prediction beyond that afforded by subacute lesion volume defined via perfusion-weighted magnetic resonance imaging (MRI). These outcomes are consistent with QEEG and other observations we have acquired from acute ischaemic stroke patients, including those who have deceased in the ensuing days. Here we report cross-temporal NIHSS, QEEG and MRI data from two such patients. Approval to carry out the study was obtained from the local University and Hospital Human Experimental Ethics committees, and informed consent was obtained from the patients’ spouses.

If potential issues such as those outlined above can be accounted for and if the delta observations presented and cited herein can be replicated in larger patient samples, such QEEG measures may become more routinely utilised in future to inform clinical prognoses and stroke patient management. For example QEEG measures, and crosstemporal changes in same, computed promptly (perhaps automatically) might help guide future clinical decisions about administration or efficacy of an intervention such as local, intra-arterial thrombolysis therapy. Further, in MCA infarction in adults under 60 years, where decompression surgery is being contemplated, such QEEG observations may assist in more timely decisions to operate. In such circumstances QEEG indices should of course be considered in concert with other (e.g. clinical and MRI) concomitant observations.
Keyword EEG
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Available online 2 May 2008.

Document type: Journal Article
Sub-type: Letter to editor, brief commentary or brief communication
Collections: Excellence in Research Australia (ERA) - Collection
UQ Centre for Clinical Research Publications
Centre for Advanced Imaging Publications
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Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 02 Feb 2010, 15:47:25 EST by Tara Johnson on behalf of Faculty of Science