A contralesional EEG power increase mediated by interhemispheric disconnection provides negative prognosis in acute stroke
A contralesional EEG power increase mediated by interhemispheric disconnection provides negative prognosis in acute stroke
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DOI：
10.3233/rnn-120244
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发表时间：
2013-01-01
影响因子：
2.8
通讯作者：
Tecchio, F.
中科院分区：
文献类型：
--
作者：
Assenza, G.;Zappasodi, F.;Tecchio, F.
背景和目的：尽管临床发病相似，但卒中的恢复情况在很大程度上是可变的。我们寻找电生理预后指标，相信他们可以指导未来的神经调节治疗促进临床recovery.Methods：19通道静息脑电图（EEG）收集42例患者4-10天后（t0）从单侧缺血性中风在大脑中动脉（MCA）的领土和20个对照。在t0和6个月后（t1）收集国家卫生研究所卒中量表（NIHSS）。标准谱带功率和interhemispherical cohesiveness之间的同源MCA区域计算在两个hemisales.Results：总频谱，δ和θ带功率均高于两侧的患者比对照组和直接相关的NIHSSt 0在两个半球。包括每个EEG患者变量的线性回归模型不同于对照组，并与有效恢复相关[ER =（NIHSSt 0-NIHSSt 1）/（健康条件下NIHSSt 0-NIHSS）]显示对侧病灶δ功率是ER的唯一有效预测因子。包括NIHSSt 0的进一步回归模型证实，对侧病灶Δ功率可增加急性临床损伤的预后信息。最好的解释是，除了增加isilesional三角洲活动，减少半球间的功能耦合-这并没有解释一个显着的部分有效的恢复variability by itself.Conclusions：脑损伤的EEG三角洲活动保留相关的负面预后信息，在急性中风患者。目前的研究结果指出，作为一个决定性的目标，在建立丰富的康复半球间的相互作用。
Background and purpose: Despite similar clinical onset, recovery from stroke can be largely variable. We searched for electrophysiological prognostic indices, believing that they can guide future neuromodulation treatments boosting clinical recovery.Methods: 19-channels resting electroencephalogram (EEG) was collected in 42 patients after 4-10 days (t0) from a unilateral ischemic stroke in the middle cerebral artery (MCA) territory and 20 controls. National Health Institute Stroke Scale (NIHSS) was collected at t0 and 6 months later (t1). Standard spectral band powers and interhemispheric coherences between homologous MCA regions were calculated in both hemispheres.Results: Total spectral, delta and theta band powers were higher bilaterally in patients than in controls and directly correlated with NIHSSt0 in both hemispheres. A linear regression model including each EEG patient's variable differing from those of controls and correlating with effective recovery [ER = (NIHSSt0-NIHSSt1)/(NIHSSt0-NIHSS in healthy conditions)] showed contralesional delta power as the only valid predictor of ER. A further regression model including also NIHSSt0 confirmed that contralesional delta power can add prognostic information to acute clinical impairment. Contralesional delta activity increase was best explained, in addition to the increasing ipsilesional delta activity, by a reduction of interhemispheric functional coupling - which did not explain a significantly portion of effective recovery variability by itself.Conclusions: Contralesional EEG delta activity retains relevant negative prognostic information in acute stroke patients. Present results point to the interhemispheric interplay as a decisive target in setting up enriched rehabilitations.