脳の異なる領域の病変を有する脳卒中患者におけるP300誘発脳電位とビデオEEGの組み合わせを用いた認知機能の評価

To evaluate the clinical utility of P300 event-related potentials combined with video electroencephalography (VEEG) in assessing post-stroke cognitive impairment (PSCI) in patients with strokes affecting different brain regions.

Stroke patients treated at our hospital were enrolled as the observation group. Based on lesion location, stroke patients were categorized into four subgroups: frontal lobe (n = 59), temporal lobe (n = 47), basal ganglia (n = 73), and brainstem (n = 35). An additional 60 age-matched healthy individuals were recruited as controls. All participants underwent cognitive assessment using the Mini-Mental State Examination (MMSE), and P300 and VEEG evaluations.

At 7 days, 1 month, 3 months, and 6 months post-treatment, MMSE scores in the observation group were significantly lower than those in the control group. Correlation analysis showed that, in the frontal- and temporal-lobe groups, P300 amplitude and VEEG α and β power at day 7 were positively correlated with MMSE scores at 6 months. In contrast, P300 latency and VEEG delta and θ power, slow-wave index, and δ/α ratio (DAR) at day 7 were negatively correlated with 6-month MMSE scores. In the basal ganglia group, day 7 P300 amplitude and VEEG α power were positively correlated with 6-month MMSE scores, whereas P300 latency, δ and θ power, and DAR were negatively correlated. In the brainstem group, P300 latency, δ power, and slow-wave index at day 7 were negatively correlated with MMSE scores at 6 months. Receiver operating characteristic (ROC) analysis demonstrated that P300 combined with VEEG predicted PSCI in the frontal lobe group with a sensitivity of 94.32%, specificity of 92.58%, and area under the curve (AUC) of 0.932 (95% CI: 0.900-0.967). For the temporal lobe group, sensitivity was 82.74%, specificity 79.27%, and AUC 0.864 (95% CI: 0.812-0.915). In the basal ganglia group, sensitivity and specificity were 78.24% and 76.12%, respectively (AUC = 0.789, 95% CI: 0.727-0.851). For the brainstem group, sensitivity was 72.78%, specificity 69.56%, and AUC 0.727 (95% CI: 0.661-0.803).

The combination of P300 and VEEG is a valuable tool for the early screening of PSCI, particularly in patients with frontal- or temporal-lobe strokes, where it shows highly predictive sensitivity and specificity.