Electroencephalographic criteria of the functional outcome prognosis in the acute period of spontaneous supratentorial intracerebral hemorrhage
DOI:
https://doi.org/10.14739/2310-1210.2020.5.214759Keywords:
cerebral hemorrhage, electroencephalography, prognosisAbstract
The aim of this study was to define electroencephalographic predictors of unfavorable functional outcome of spontaneous supratentorial intracerebral hemorrhage (SSICH) in the acute period.
Materials and methods. Prospective, cohort and comparative study was conducted in 114 patients (mean age 67.4 ± 0.8 years) in the acute period of SSICH. Electroencephalography (EEG) was conducted on the 1st–2nd day of the disease. The values of relative band spectral powers of delta rhythm (0.5–4.0 Hz), theta (4–8 Hz), alpha (8–13 Hz), beta (13–35 Hz), theta1 (4–6 Hz), theta2 (6–8 Hz), alpha1 (8–10 Hz), alpha2 (10–13 Hz), beta1 (13–25 Hz) and beta2 (25–35 Hz) were determined in the affected and intact hemispheres. The fronto-occipital rhythm gradient and the severity of interhemispheric rhythm asymmetry were calculated. The functional outcome of the disease in the acute period was assessed on day 21 based on the modified Rankin Scale (mRS), and the value of mRS score >3 was considered as an unfavorable functional outcome.
Results. Unfavorable functional outcome of the SSICH in the acute period was registered in 53 (46.5 %) patients. Independent association with the risk of unfavorable functional outcome of SSICH in the acute period was proved for the following indexes of the spectral analysis of EEG pattern in the first 2 days from the onset of the disease: the relative delta band spectral power in the affected hemisphere (OR (95 % CI) = 1.18 (1.11–1.25), P ˂ 0.0001) and the fronto-occipital rhythm gradient of beta band in the affected hemisphere (OR (95 % CI) = 0.0007 (0.0001–0.0293), P = 0.0001). These predictors were integrated in the mathematical model for the determination of an individual risk of unfavorable functional outcome of SSICH in the acute period (AUC (95 % CI) = 0.94 (0.88–0.98), P ˂ 0.0001; forecast accuracy = 87.7 %).
Conclusions. Bilateral shift of EEG spectral power pattern of rhythms towards slow-wave activity of the hemisphere with the formation of interhemispheric asymmetry of delta band rhythms in the frontal areas, bilateral reduction in zonal differences of alpha band rhythms, the inversion of the fronto-occipital rhythm gradient of beta band in the affected hemisphere and the reduction in zonal differences of beta band rhythms due to beta2 band in the intact hemisphere with the formation of multidirectional interhemispheric asymmetry in the frontal and occipital parts of the brain in the first 2 days upon the onset of SSICH are considered as EEG criteria for unfavorable functional outcome of the disease in the acute period.
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