Poststroke QEEG informs early prognostication of cognitive impairment
Emma Schleiger
The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
School of Medicine, The University of Queensland, Brisbane, Australia
Search for more papers by this authorAndrew Wong
School of Medicine, The University of Queensland, Brisbane, Australia
Acute Stroke Unit, Neurology Department, Royal Brisbane and Women's Hospital, Herston, Australia
Search for more papers by this authorStephen Read
School of Medicine, The University of Queensland, Brisbane, Australia
Search for more papers by this authorTennille Rowland
Acute Stroke Unit, Neurology Department, Royal Brisbane and Women's Hospital, Herston, Australia
Occupational Therapy Department, Royal Brisbane and Women's Hospital, Herston, Australia
Search for more papers by this authorCorresponding Author
Simon Finnigan
The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Herston, Australia
Address correspondence to: Simon Finnigan, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia. E-mail: [email protected]Search for more papers by this authorEmma Schleiger
The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
School of Medicine, The University of Queensland, Brisbane, Australia
Search for more papers by this authorAndrew Wong
School of Medicine, The University of Queensland, Brisbane, Australia
Acute Stroke Unit, Neurology Department, Royal Brisbane and Women's Hospital, Herston, Australia
Search for more papers by this authorStephen Read
School of Medicine, The University of Queensland, Brisbane, Australia
Search for more papers by this authorTennille Rowland
Acute Stroke Unit, Neurology Department, Royal Brisbane and Women's Hospital, Herston, Australia
Occupational Therapy Department, Royal Brisbane and Women's Hospital, Herston, Australia
Search for more papers by this authorCorresponding Author
Simon Finnigan
The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Herston, Australia
Address correspondence to: Simon Finnigan, UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia. E-mail: [email protected]Search for more papers by this authorThis study was funded in part by the University of Queensland, the Royal Brisbane and Women's Hospital Foundation, and the National Stroke Foundation (Australia). SF was supported in part by a Career Development Award from the National Health and Medical Research Council (Australia). ES was supported by a Royal Brisbane and Women's Hospital Postgraduate Scholarship.
Abstract
Cognitive impairment is a common consequence of stroke, but remains difficult to predict. We investigate the ability of early QEEG assessment to inform such prediction, using binary logistic regression. Thirty-five patients (12 female, ages 18–87) suffering middle cerebral artery, ischemic stroke were studied. Resting-state EEG was recorded 48–239 h after symptom onset. Relative power for delta, theta, alpha, and beta bands, delta:alpha ratio, and peak alpha frequency were analyzed. Montreal Cognitive Assessment (MoCA) was administered, where possible, on day of EEG and at median 99 days (range 69–138) poststroke. Eight patients could not complete the baseline MoCA, and four the follow-up MoCA, for varying reasons (most commonly, stroke symptoms). Fifteen patients (48%) had cognitive impairment (MoCA score ≤25) at follow-up. One QEEG index was able to correctly predict presence/absence of cognitive impairment in 24/31 patients (77.4%), whereas predischarge MoCA did so in 23 patients. This index, relative theta frequency (4–7.5 Hz) power, was computed from only three posterior electrodes over the stroke-affected hemisphere. Its predictive accuracy (three electrodes) was higher than that of any “global” QEEG measure (averaged over 19 electrodes). These results may signify association between poststroke alpha slowing and cognitive impairment, which may be mediated by attentional (dys)function, which warrants further investigation. Pending further studies, QEEG measure(s)—from a few electrodes—could inform early prognostication of poststroke cognitive outcomes (and clinical decisions), particularly when cognitive function cannot be adequately assessed (due to symptoms, language, or other issues) or when assessment is equivocal.
Supporting Information
Additional supporting information may be found in the online version of this article:
| Filename | Description |
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| psyp12785-sup-0001-suppinfo1.docx16.4 KB | Table S1: Coefficients of the supplementary QEEG regression models predicting poststroke cognitive impairment. |
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