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Alpha power decrease in quantitative EEG detects development of cerebral infarction after subarachnoid hemorrhage early.

Authors :
Mueller TM
Gollwitzer S
Hopfengärtner R
Rampp S
Lang JD
Stritzelberger J
Madžar D
Reindl C
Sprügel MI
Dogan Onugoren M
Muehlen I
Kuramatsu JB
Schwab S
Huttner HB
Hamer HM
Source :
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2021 Jun; Vol. 132 (6), pp. 1283-1289. Date of Electronic Publication: 2021 Mar 26.
Publication Year :
2021

Abstract

Objective: In subarachnoid hemorrhage (SAH), transcranial Doppler/color-coded-duplex sonography (TCD/TCCS) is used to detect delayed cerebral ischemia (DCI). In previous studies, quantitative electroencephalography (qEEG) also predicted imminent DCI. This study aimed to compare and analyse the ability of qEEG and TCD/TCCS to early identify patients who will develop later manifest cerebral infarction.<br />Methods: We analysed cohorts of two previous qEEG studies. Continuous six-channel-EEG with artefact rejection and a detrending procedure was applied. Alpha power decline of ≥ 40% for ≥ 5 hours compared to a 6-hour-baseline was defined as significant EEG event. Median reduction and duration of alpha power decrease in each channel was determined. Vasospasm was diagnosed by TCD/TCCS, identifying the maximum frequency and days of vasospasm in each territory.<br />Results: 34 patients were included (17 male, mean age 56 ± 11 years, Hunt and Hess grade: I-V, cerebral infarction: 9). Maximum frequencies in TCD/TCCS and alpha power reduction in qEEG were correlated (r = 0.43; p = 0.015). Patients with and without infarction significantly differed in qEEG parameters (maximum alpha power decrease: 78% vs 64%, p = 0.019; summed hours of alpha power decline: 236 hours vs 39 hours, p = 0.006) but showed no significant differences in TCD/TCCS parameters.<br />Conclusions: There was a moderate correlation of TCD/TCCS frequencies and qEEG alpha power reduction but only qEEG differentiated between patients with and without cerebral infarction.<br />Significance: qEEG represents a non-invasive, continuous tool to identify patients at risk of cerebral infarction.<br />Competing Interests: Declaration of Competing Interest Tamara M. Müller, Rüdiger Hopfengärtner, Stephan Rampp, Johannes Lang, Jenny Stritzelberger, Caroline Reindl, Maximilian I. Sprügel, Müjgan Dogan Onugoren, Iris Muehlen, Joji B. Kuramatsu, Stefan Schwab: report no disclosures. Stephanie Gollwitzer reports personal fees from Desitin, Eisai, UCB, outside the submitted work. Dominik Madžar reports grants from UCB Pharma and BayerVitalGmbH, outside submitted work. Hagen B. Huttner reports grants from Novartis, grants and personal fees from Bayer AG, grants and personal fees from Daiichi Sankyo, grants and personal fees from Medtronic, grants and personal fees from Portola Pharmaceuticals, outside the submitted work. Hajo M. Hamer: reports personal fees from UCB, Desitin, Eisai, GW, Novartis, IQWiG, Hexal, facetoface, grants from Amgen, Ad-Tech, Bracco, Pfizer, Micromed, Nihon Kohden, personal fees from Arvelle, outside the submitted work.<br /> (Copyright © 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
1872-8952
Volume :
132
Issue :
6
Database :
MEDLINE
Journal :
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
Publication Type :
Academic Journal
Accession number :
33867261
Full Text :
https://doi.org/10.1016/j.clinph.2021.03.005