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Additional Value of Quantitative EEG in Ischemic Stroke.

机译：定量脑电图在缺血性卒中中的附加价值。

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摘要

Stroke is among the leading causes for adult-onset disability and death worldwide, carrying an enormous psycho-social burden and a significant impact on health resources.;The general aim of this PhD work was to evaluate the additional value of quantitative electro-encephalography (EEG) in ischemic stroke with regard to clinically relevant state and outcome measures. An essentially pragmatic design was specifically implemented to extrapolate our findings directly to routine clinical practice with limited resources.;In a methodological analysis, we found a high level of intra-record, intra-rater and inter-rater reproducibility of quantitative EEG spectral parameters. We introduce the single channel pair averaged revised spatial Brain Symmetry Index (pdBSI) which evaluates asymmetry along homologous channel pairs. In acute anterior circulation syndrome of presumed ischemic origin, pdBSI emerged as the only independent predictor for radiologically confirmed stroke and early neurological deterioration while spontaneous early neurological improvement was independently predicted by the (delta + theta / alpha + beta) -- ratio (DTABR) and volume of recent infarction.;In patients presenting with a lacunar (LACS) or posterior circulation syndrome (POCS), definite stroke was independently predicted by pdBSI, even in patients without neurological deficits at the time of EEG recording. Unfavourable outcome at day 7 was predicted by DTABR in LACS but not in POCS.;The National Institute of Health Stroke Scale (NIHSS) score and pdBSI emerged as statistically significant independent predictors for disability six months after ischemic stroke. Dependency six months after ischemic stroke was independently predicted by NIHSS and DTABR.;Age at stroke onset, NIHSS and DTABR emerged as statistically significant independent predictors for death six months after ischemic stroke.;Our findings suggest that EEG monitoring in the acute and subacute phase may be useful in all ischemic stroke types regardless of localisation, OCSP classification, previous stroke, or use of psychotropic medication.;Based on its superior predictive value for short-term and long-term outcome, its versatility and relative inexpensiveness, early quantitative EEG might be considered a routine evaluation tool in the assessment of patients presenting with ischemic stroke.
机译：脑卒中是全球成人成年残疾和死亡的主要原因之一，它承担着巨大的社会心理负担，并严重影响卫生资源。这项博士研究的总体目的是评估定量脑电图的附加价值（脑缺血性脑卒中的临床相关状态和结果指标。专门实施了一种基本务实的设计，将我们的发现直接用于资源有限的常规临床实践中。在方法学分析中，我们发现定量EEG频谱参数在记录内，评估者内和评估者间具有较高的可重复性。我们介绍了单通道对平均修正空间脑对称指数（pdBSI），该指数评估沿同源通道对的不对称性。在推测为缺血性起源的急性前循环综合征中，pdBSI成为放射学证实的卒中和早期神经系统恶化的唯一独立预测因子，而自发的早期神经系统改善则通过（δ+ theta / alpha + beta）-比（DTABR）独立预测在患有腔隙性（LACS）或后循环综合征（POCS）的患者中，即使在脑电图记录时无神经功能缺损的患者中，pdBSI也可以独立预测明确的中风。 DTABR在LACS中预测了在第7天的不良结局，而在POCS中则没有预测。国立卫生研究院卒中量表（NIHSS）评分和pdBSI成为缺血性卒中后六个月的残疾的统计显着独立预测因子。 NIHSS和DTABR独立预测缺血性卒中后六个月的依赖性;在卒中发作的年龄，NIHSS和DTABR成为缺血性卒中后六个月死亡的统计学上重要的独立预测因子;我们的研究结果表明，在急性和亚急性期进行脑电图监测可能适用于所有缺血性卒中类型，无论其定位，OCSP分类，既往卒中还是使用精神药物。;基于其对短期和长期结果的优越预测价值，多功能性和相对便宜性，早期定量EEG在评估缺血性卒中患者时，可能被视为常规评估工具。

著录项

  • 作者

    Sheorajpanday, Rishi.;

  • 作者单位

    Universiteit Antwerpen (Belgium).;

  • 授予单位 Universiteit Antwerpen (Belgium).;
  • 学科 Biology Neuroscience.;Biophysics Medical.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 227 p.
  • 总页数 227
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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