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Alpha-band activity in density spectral array predictive for neurological outcome in patients with hypoxic-ischemic
Narumi Ohno1, Shuichiro Neshige1, Megumi Nonaka2
1Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan; Epilepsy Center, Hiroshima University Hospital, Hiroshima, Japan.
Background:
In patients with hypoxic-ischemic encephalopathy (HIE), EEG is used to predict outcomes. However, a clear threshold for EEG findings associated with favorable outcomes remains unestablished. This study evaluates the predictive value of density spectral array (DSA)-based background activity in HIE patients.
Methods:
Forty-four consecutive HIE patients with disturbance of consciousness (2010-2023) were retrospectively assessed and categorized into highly malignant, malignant, or benign EEG patterns according to the conventional EEG classification. The presence of alpha-band activity, defined as an increase in alpha (or theta) frequency band power visible in the DSA, was also assessed. The relationship among conventional EEG classification, alpha-band activity, and neurological outcomes was evaluated.
Results:
All patients with highly malignant EEG lacked alpha-band activity and experienced poor outcomes, whereas those with less severe patterns occasionally exhibited alpha-band activity (14 % in the malignant vs. 60 % in the benign, p = 0.021), and demonstrated various outcomes. Recovery of consciousness until discharge was more prominent in patients with alpha-band activity compared to those without (100 % vs. 39 %, p < 0.001).
Conclusions:
DSA-based evaluations provide a simple and valuable tool for predicting favorable neurological outcomes.
