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Published on: July 14, 2023
Reproducibility and clinical relevance of quantitative EEG parameters in cerebral ischemia: a basic approach
Rishi V A Sheorajpanday1, Guy Nagels, Arie J T M Weeren
1Department of Neurology and Memory Clinic, ZNA Middelheim Hospital, Antwerp, Belgium.
Insights
The pair-wise derived Brain Symmetry Index (pdBSI) shows high reproducibility in EEG analysis for stroke patients. This quantitative EEG measure reliably differentiates stroke from control subjects and correlates with clinical and imaging data.
Area of Science:
- Neuroscience
- Medical Imaging
- Biomedical Engineering
Background:
- Quantitative electroencephalography (qEEG) offers potential for assessing neurological conditions.
- Ischemic cerebrovascular disease requires reliable methods for diagnosis and monitoring.
- Reproducibility and clinical relevance of qEEG parameters in stroke populations need further investigation.
Purpose of the Study:
- To evaluate the reproducibility and clinical significance of qEEG parameters in patients with ischemic cerebrovascular disease.
- To assess the reliability of standard EEG measures and a novel pair-wise derived Brain Symmetry Index (pdBSI).
- To determine correlations between qEEG findings, clinical status, and neuroimaging data.
Main Methods:
- EEG recordings were obtained from 31 subacute ischemic cerebrovascular disease patients and 10 age-matched controls.
- Intra-recording, intrarater, and interrater reproducibility were calculated for standard EEG and pdBSI.
- Correlations were analyzed between EEG parameters, NIH Stroke Scale, and diffusion-weighted imaging (DWI) lesion volume.
Main Results:
- The pdBSI demonstrated sensitivity to asymmetry in both amplitude and frequency domains.
- High reproducibility (Cronbach's alpha 0.95-0.99) was observed for both standard spectral parameters and pdBSI.
- Significant differences in pdBSI were found between stroke patients and controls/TIA patients (p=0.0003).
- pdBSI strongly correlated with NIH Stroke Scale (rho=0.64-0.70) and DWI volume (rho=0.79-0.84).
Conclusions:
- The pair-wise derived Brain Symmetry Index (pdBSI) exhibits high, multi-level reproducibility.
- pdBSI effectively distinguishes stroke patients from control or TIA subjects.
- EEG parameters, particularly pdBSI, are clinically relevant for assessing stroke status and outcomes.
Objective:
To investigate reproducibility and clinical relevance of quantitative EEG parameters in ischemic cerebrovascular disease.
Methods:
EEG was recorded in 31 patients suffering from subacute ischemic cerebrovascular disease. Ten age-matched control subjects were included as a reference group. Intra-recording, intrarater and interrater reproducibility was calculated for standard EEG measures and for a pair wise derived Brain Symmetry Index (pdBSI). Correlations between EEG parameters, clinical status and volume of ischemia on diffusion weighted imaging (DWI) were calculated.
Results:
pdBSI was sensitive to asymmetry in the amplitude and frequency domain in a random white noise model and in a simulated sinusoidal model. Minimal Cronbach alpha for intra-recording, intra- and inter-rater reproducibility ranged between 0.95 and 0.99 for standard spectral parameters and between 0.96 and 0.99 for pdBSI. We found a significant difference in pdBSI between stroke patients and control or TIA (p=0.0003). pdBSI correlated significantly with NIH stroke scale at admission and DWI volume across different levels of stroke probability (Spearman's rho=0.64-0.70 and 0.79-0.84, respectively, p<0.00001 for both).
Conclusions:
pdBSI displays high multilevel reproducibility and reliably discriminates between stroke and TIA patients or control subjects, and correlates significantly with clinical and radiological status.
Significance:
Based on this methodological analysis, reliable EEG parameters can be evaluated in a general stroke population for clinically relevant state and outcome measures.
