Abstract：
OBJECTIVE: We aimed to determine whether quantitative electroencephalography (QEEG) measures have predictive value for cerebral edema (CED) and clinical outcomes in acute ischemic stroke (AIS) patients with anterior circulation large vessel occlusion who underwent mechanical thrombectomy (MT).
METHODS: A total of 105 patients with AIS in the anterior circulation were enrolled in this prospective study. The occurrence and severity of CED were assessed through computed tomography conducted 24 h after MT. Clinical outcomes were evaluated based on early neurological deterioration (END) and 3-month functional status, as measured by the modified Rankin scale (mRS). Electroencephalography (EEG) recordings were performed 24 h after MT, and QEEG indices were calculated from the standard 16 electrodes and 2 frontal channels (F3-C3, F4-C4). The delta/alpha ratio (DAR), the (delta + theta) / (alpha + beta) ratio (DTABR), and relative delta power were averaged over all electrodes (global) and the F3-C3 and F4-C4 channels (frontal). The predictive effect and value of QEEG indices for CED and clinical outcomes were assessed using ordinal and logistic regression models, as well as receiver operating characteristic (ROC) curves.
RESULTS: Significantly, both global and frontal DAR were found to be associated with the severity of CED, END, and poor functional outcomes at 90 days, while global and frontal DTABR and relative delta power were not associated with outcomes. In ROC analysis, the best predictive effect was observed in frontal DAR, with an area under the curve of approximately 0.80. It exhibited approximately 75% sensitivity and 71% specificity for radiological and clinical outcomes when a threshold of 3.3 was used.
CONCLUSIONS: QEEG techniques may be considered an efficient bedside monitoring method for assessing treatment efficacy, identifying patients at higher risk of severe CED and END, and predicting long-term functional outcomes.
CONCLUSIONS: QEEG can help identify patients at risk of severe neurological complications that can impact long-term functional recovery in AIS patients who underwent MT.
METHODS: A total of 105 patients with AIS in the anterior circulation were enrolled in this prospective study. The occurrence and severity of CED were assessed through computed tomography conducted 24 h after MT. Clinical outcomes were evaluated based on early neurological deterioration (END) and 3-month functional status, as measured by the modified Rankin scale (mRS). Electroencephalography (EEG) recordings were performed 24 h after MT, and QEEG indices were calculated from the standard 16 electrodes and 2 frontal channels (F3-C3, F4-C4). The delta/alpha ratio (DAR), the (delta + theta) / (alpha + beta) ratio (DTABR), and relative delta power were averaged over all electrodes (global) and the F3-C3 and F4-C4 channels (frontal). The predictive effect and value of QEEG indices for CED and clinical outcomes were assessed using ordinal and logistic regression models, as well as receiver operating characteristic (ROC) curves.
RESULTS: Significantly, both global and frontal DAR were found to be associated with the severity of CED, END, and poor functional outcomes at 90 days, while global and frontal DTABR and relative delta power were not associated with outcomes. In ROC analysis, the best predictive effect was observed in frontal DAR, with an area under the curve of approximately 0.80. It exhibited approximately 75% sensitivity and 71% specificity for radiological and clinical outcomes when a threshold of 3.3 was used.
CONCLUSIONS: QEEG techniques may be considered an efficient bedside monitoring method for assessing treatment efficacy, identifying patients at higher risk of severe CED and END, and predicting long-term functional outcomes.
CONCLUSIONS: QEEG can help identify patients at risk of severe neurological complications that can impact long-term functional recovery in AIS patients who underwent MT.
摘要：
目的：我们的目的是确定定量脑电图（QEEG）检测对急性缺血性卒中（AIS）伴机械血栓切除术（MT）的前循环大血管闭塞患者的脑水肿（CED）和临床结局是否具有预测价值。
方法：本前瞻性研究共纳入105例前循环AIS患者。通过MT后24小时进行计算机断层扫描评估CED的发生和严重程度。根据早期神经功能恶化（END）和3个月功能状态评估临床结果。如通过改进的Rankin量表(mRS)测量的。MT后24小时进行脑电图（EEG）记录，根据标准的16个电极和2个额叶通道（F3-C3，F4-C4）计算QEEG指数。δ/α比(DAR)，(δ+θ)/(α+β)比率(DTABR)，在所有电极(全局)和F3-C3和F4-C4通道(正面)上对相对增量功率进行平均。使用序数和logistic回归模型评估QEEG指标对CED和临床结局的预测效果和价值。以及接收器工作特性(ROC)曲线。
结果：重要的是，发现整体和额叶DAR都与CED的严重程度相关，结束,90天的功能效果不佳，而全球和额叶DTABR和相对delta功率与结局无关.在ROC分析中，在额叶DAR中观察到最好的预测效果，曲线下的面积约为0.80。当使用3.3的阈值时，它对放射学和临床结果表现出大约75％的敏感性和71％的特异性。
结论：QEEG技术可能被认为是评估治疗疗效的有效床边监测方法，确定严重CED和END风险较高的患者，并预测长期功能结果。
结论：QEEG可以帮助识别患有严重神经系统并发症的患者，这些并发症会影响接受MT的AIS患者的长期功能恢复。
方法：本前瞻性研究共纳入105例前循环AIS患者。通过MT后24小时进行计算机断层扫描评估CED的发生和严重程度。根据早期神经功能恶化（END）和3个月功能状态评估临床结果。如通过改进的Rankin量表(mRS)测量的。MT后24小时进行脑电图（EEG）记录，根据标准的16个电极和2个额叶通道（F3-C3，F4-C4）计算QEEG指数。δ/α比(DAR)，(δ+θ)/(α+β)比率(DTABR)，在所有电极(全局)和F3-C3和F4-C4通道(正面)上对相对增量功率进行平均。使用序数和logistic回归模型评估QEEG指标对CED和临床结局的预测效果和价值。以及接收器工作特性(ROC)曲线。
结果：重要的是，发现整体和额叶DAR都与CED的严重程度相关，结束,90天的功能效果不佳，而全球和额叶DTABR和相对delta功率与结局无关.在ROC分析中，在额叶DAR中观察到最好的预测效果，曲线下的面积约为0.80。当使用3.3的阈值时，它对放射学和临床结果表现出大约75％的敏感性和71％的特异性。
结论：QEEG技术可能被认为是评估治疗疗效的有效床边监测方法，确定严重CED和END风险较高的患者，并预测长期功能结果。
结论：QEEG可以帮助识别患有严重神经系统并发症的患者，这些并发症会影响接受MT的AIS患者的长期功能恢复。
