Quantitative EEG as a diagnostic and prognostic tool in hemispheric stroke patients undergoing type A aortic dissection surgery

Ya-Peng Wang; Wen-Xue Liu; Yi Jiang; Shan Lu; Yong-Qing Cheng; Yang Chen; Dong-Jin Wang

doi:10.1002/brb3.3091

Quantitative EEG as a diagnostic and prognostic tool in hemispheric stroke patients undergoing type A aortic dissection surgery

Brain Behav. 2023 Jul;13(7):e3091. doi: 10.1002/brb3.3091. Epub 2023 May 21.

Authors

Ya-Peng Wang¹, Wen-Xue Liu^{2

3}, Yi Jiang¹, Shan Lu^{2

3}, Yong-Qing Cheng^{2

3}, Yang Chen^{2

3}, Dong-Jin Wang^{1

2

3}

Affiliations

¹ Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China.
² Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
³ Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing, China.

Abstract

Objective: The diagnostic and prognostic value of quantitative electroencephalogram (qEEG) parameters, specifically the symmetry of amplitude-integrated electroencephalography (aEEG) and relative band power (RBP), in the postoperative stroke of the cerebral hemisphere following type A aortic dissection, remains an area of inquiry.

Methods: We analyzed and processed 56 patients with type A aortic dissection who underwent bedside qEEG monitoring and analyzed the qEEG indices, brain CT, and clinical data of these patients. qEEG (symmetry of aEEG and RBP, and affected/unaffected hemisphere) indices were analyzed at discharge and 60 days after discharge.

Results: A total of 56 patients were studied. The 60-day mortality rate was 12.5%. The affected hemisphere's diagnosis and mortality after 1-year follow-up were evaluated, and RBP beta demonstrated the highest area under the curve values with 95% confidence intervals (CI) of .849 (95% CI: .771-.928) and .91 (95% CI: .834-.986), respectively. According to the results of the logistic regression analysis, we have identified the strongest predictors for cerebral hemisphere stroke and 1-year mortality in stroke patients. Specifically, aEEGmin exhibited the highest predictive power with an odds ratio (OR) of .735 for cerebral hemisphere stroke, whereas DTABR was confirmed as one of the strongest predictors with an OR of 1.619 for 1-year mortality in stroke patients, indicating a high level of reliability. Spearman correlation coefficients showed that aEEGmax and aEEGmin were positively correlated with Alberta Stroke Program Early CT Score (aEEGmax: rho = .50, p < .001; aEEGmin: rho = .44, p < .001).

Conclusions: QEEG has been proven to be a sensitive indicator for monitoring brain function and can be monitored continuously. It can help clinicians detect and treat these patients early and improve long-term prognosis.

Keywords: amplitude-integrated electroencephalography; quantitative EEG; relative band power; stroke; type A aortic dissection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Electroencephalography / methods
Humans
Prognosis
Reproducibility of Results
Stroke* / diagnosis