QUANTITATIVE EEG (BRAIN

MAPPING) IN ACUTE ISCHEMIC

STROKE

AUTHOR
• Asmedi, Ditha, Dyanne : Electromedic Clinic
• Abdul Gofir : Neurobehaviour
• Paryono : Cerebrovascular
• Wahyu Wihartono : RSPAU Harjolukito
• Zamroni, Sekar Satiti : RS PKU
Muhammadiyah
 BACKGROUND
INITIAL STROKE SEVERITY
NIHSS

FUNCTIONAL
LOCATION
STROKE ACUTE
PHASE
RADIOLOGY COGNITIVE IMPAIRMENT

EXTENTION
MOCA INA
VASCULAR RISK FACTOR
qEEG DEMOGRAPHIC
OBJECTIVE

To know whether quantitative EEG (qEEG)

related to severity of neurological deficit
(NIHSS ) and cognitive impairment (MOCA-
INA) in acute ischemic stroke
Subjects &
Methods
 Acute ischemic stroke patient January – March 2018

RSS and RSPAU Hardjolukito (Stroke Unit) N = 31

Inclusion Exclusion

SUBJECTS N = 28

Electromedic Clinical Laboratory Radiology

- sex, age - Blood glucose

qEEG -
-
hypertension
NIHSS
-
-
Cholesterol
TG HCTS
- HDL  ASPECT
- Moca-Ina - LDL

ANALYSIS
- Absolute STASTIC
power
- DAR
- DTABR
qEEG AQCUISITION

T
E
C
H
N
I
C
I
A
N
qEEG ACQUISITION

DAR
Delta / Alpha Power Ratio

DTABR
(Delta+Tetha)/(Alpha+Beta)
Ratio
RESULTS
DEMOGRAPHIC DATA
Characteristics Total Characteristics Total
Age
• 55 years old 22 (73,3%) Area of Lesion
• < 55 years old 8 (26.7%) • High Risk (<7) 7 (23,3%)
Gender • Low Risk (>7) 23 (76,7%)
• Male 15 (50%)
Lesion
• Female 15 (50%)
• Cortical 6 (20%)
Hypertension
• Yes 28 (93,3%)
• Subcortical 15 (50%)
• No 2 (6,7%) • Both 4 (13,3%)
Diabetes mellitus • Normal 5 (16,7%)
• Yes 6 (20%)
• No 24 (80%)
Dyslipidemia
• Yes 17 (56,7%)
• No 13 (43,3%)
qEEG VS NIHSS and MOCA-Ina
Bivariate Spearman correlation analysis

qEEG NIHSS MOCA-INA

Parameter
Correlation (r) P Correlation (r) p
Tetha power 0,489 0,461 -0,155 0,414
Alpha power -0,157 0,426 0,034 0,859
Betha power -0,162 0,410 0,004 0,985
Delta power 0,141 0,473 -0,654 0,001*
DAR 0,419 0,026* -0,371 0,043*
DTABR 0,453 0,015* -0,397 0,030*
VASCULAR RISK FACTOR
Bivariate Spearman correlation analysis

Vascular risk NIHSS MOCA INA

factor Correlation (r) p Correlation P
Age 0,304 0,102 0,003 0,987
Systolic 0,007 0,971 -0,326 0,079
Fasting glucose -0,105 0,581 -0,142 0,455
Triglyceride -0,305 0,101 -0,281 0,133
LDL -0,328 0,077 -0,618 0,001*
HDL 0,071 0,709 0,492 0,006*
Cholesterol -0,442 0,015* -0,586 0,001*
RADIOLOGIC, qEEG VS NIHSS, MOCA-Ina

MOCA-INA NIHSS

Correlation (r) p Correlation (r) p

RADIOLOGY ASPECT 0,162 0,393 -0,572 0,001*

Delta -0,654 0,001* 0,141 0,473

power
qEEG DAR -0,371 0,043* 0,419 0,026*

DTABR -0,397 0,030* 0,453 0,015*

DAR VS NIHSS DTABR VS NIHSS DELTA POWER VS MOCA-INA
DISCUSSION

Quantitative EEG parameters such as delta power, DAR, and

DTABR correlate with severity of stroke (1)
Delta power and theta power related qEEG metric may detect the
biochemical changes associated with a brain moving into infarct
state (1).
EEG Power represents the sum of neuron discharging
synchronously (2,3).
EEG power may also be a measure that reflect the capacity or
performance of cortical information processing (3).
CONCLUSION

• qEEG parameter (especially delta power, DAR and

DTABR), significantly correlated with functional and
cognitive impairment in stroke acute phase.
• The current result indicate delta power, DAR and
DTABR prior to discharge may uniquely informed
early screening for post stroke functional and
cognitive impairment
Refference
1. Aminov, A., Rogers, J. M., Johnstone, S. J., Middleton, S., Wilson, P. H.
2017. Acute single channel EEG predictors of cognitive function after
stroke. PLoS ONE, 12(10), 1–15.
2. Foreman, B and Claassen, J. 2012 Quantitative EEG for the detection of
brain ischemia. Critical Care. Vol 16: 216.
3. Kanda, P.A., Anghinah, R., Smidth, M.T., Silva, J.M. 2009. The clinical use
of quantitative EEG in cognitive disorders. Dementia and
Neurophysiologia. Vol 3(3):195-203.
4. Song, Y., Zang, D.W., Jin, Y., Wang, Z.J., Ni, H.Y., Yin, J.Z. 2015.
Background Ryhthm Frequency and Theta Power of quantitative EEG
Analysus: Predictive Biomarkers for Cognitive Impairement Post
Cerebral Infarct. Clinical EEG and Neuroscience. Vol 46(2)142-146.
RABBANA
ZIDNA ‘ILMAN