Prognostic Value of EEG Microstates in Acute Stroke
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Published on: July 14, 2023
Filippo Zappasodi1,2, Pierpaolo Croce3,4, Alessandro Giordani5
1Department of Neuroscience, Imaging and Clinical Sciences, "Gabriele d'Annunzio" University of Chieti-Pescara, via dei Vestini 31, 66100, Chieti, Italy. f.zappasodi@unich.it.
Abstract:
Given the importance of neuronal plasticity in recovery from a stroke and the huge variability of recovery abilities in patients, we investigated neuronal activity in the acute phase to enhance information about the prognosis of recovery in the stabilized phase. We investigated the microstates in 47 patients who suffered a first-ever mono-lesional ischemic stroke in the middle cerebral artery territory and in 20 healthy control volunteers. Electroencephalographic (EEG) activity at rest with eyes closed was acquired between 2 and 10 days (T0) after ischemic attack. Objective criteria allowed for the selection of an optimal number of microstates. Clinical condition was quantified by the National Institute of Health Stroke Scale (NIHSS) both in acute (T0) and stabilized (T1, 5.4 ± 1.7 months) phases and Effective Recovery (ER) was calculated as (NIHSS(T1)-NIHSS(T0))/NIHSS(T0). The microstates A, B, C and D emerged as the most stable. In patients with a left lesion inducing a language impairment, microstate C topography differed from controls. Microstate D topography was different in patients with a right lesion inducing neglect symptoms. In patients, the C vs D microstate duration differed after both a left and a right lesion with respect to controls (C lower than D in left and D lower than C in right lesion). A preserved microstate B in acute phase correlated with a better effective recovery. A regression model indicated that the microstate B duration explained the 11% of ER variance. This first ever study of EEG microstates in acute stroke opens an interesting path to identify neuronal impairments with prognostic relevance, to develop enriched compensatory treatments to drive a better individual recovery.
Insights
Early EEG microstate analysis in stroke patients predicts recovery. Preserved microstate B in the acute phase correlates with better effective recovery, offering prognostic insights for personalized stroke rehabilitation.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Neuronal plasticity is crucial for stroke recovery, yet recovery varies significantly among patients.
- Understanding acute-phase neuronal activity may improve stroke prognosis prediction.
Purpose of the Study:
- To investigate electroencephalographic (EEG) microstates in the acute phase after ischemic stroke.
- To correlate EEG microstate characteristics with clinical outcomes and effective recovery.
Main Methods:
- EEG recordings were obtained from 47 acute ischemic stroke patients and 20 controls.
- Microstate analysis identified stable EEG patterns (A, B, C, D).
- Clinical status was assessed using the National Institute of Health Stroke Scale (NIHSS) at acute (T0) and stabilized (T1) phases.
Main Results:
- Microstate C topography differed in left-lesion patients with language impairment; microstate D differed in right-lesion patients with neglect symptoms.
- Microstate durations (C vs. D) varied in patients compared to controls based on lesion side.
- A preserved microstate B in the acute phase correlated with better effective recovery (ER).
Conclusions:
- EEG microstates in the acute stroke phase show prognostic relevance for recovery.
- Microstate B duration explained 11% of the variance in effective recovery.
- This study highlights EEG microstates as a potential tool for identifying neuronal impairments and guiding personalized stroke treatments.
