Quantitative EEG as a Biomarker in Evaluating Post-Stroke Depression

Abstract

Introduction: Post-stroke depression (PSD) has complex pathophysiology determined by various biological and psychological factors. Although it is a long-term complication of stroke, PSD is often underdiagnosed. Given the diagnostic role of quantitative electroencephalography (qEEG) in depression, it was investigated whether a possible marker of PSD could be identified by observing the evolution of the (Delta + Theta)/(Alpha + Beta) Ratio (DTABR), respectively the Delta/Alpha Ratio (DAR) values in post-stroke depressed patients (evaluated through the HADS-D subscale). Methods: The current paper analyzed the data of 57 patients initially selected from a randomized control trial (RCT) that assessed the role of N-Pep 12 in stroke rehabilitation. EEG recordings from the original trial database were analyzed using signal processing techniques, respecting the conditions (eyes open, eyes closed), and several cognitive tasks. Results: We observed two significant associations between the DTABR values and the HADS-D scores of post-stroke depressed patients for each of the two visits (V1 and V2) of the N-Pep 12 trial. We recorded the relationships in the Global (V1 = 30 to 120 days after stroke) and Frontal Extended (V2 = 90 days after stroke) regions during cognitive tasks that trained attention and working memory. For the second visit, the association between the analyzed variables was negative. Conclusions: As both our relationships were described during the cognitive condition, we can state that the neural networks involved in processing attention and working memory might go through a reorganization process one to four months after the stroke onset. After a period longer than six months, the process could localize itself at the level of frontal regions, highlighting a possible divergence between the local frontal dynamics and the subjective well-being of stroke survivors. QEEG parameters linked to stroke progression evolution (like DAR or DTABR) can facilitate the identification of the most common neuropsychiatric complication in stroke survivors.

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“…The interpretation of DTABR extends to the evaluation of cognitive functioning, where abnormalities in this ratio may indicate potential alterations in cognitive processes. Scientific evidence has linked abnormal DTABR values to various neurological conditions, emphasizing the significance of this measure in understanding the complexities of brain activity and its implications for cognitive health [ 6 , 10 - 13 ].…”

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“…It is displayed in the form of a curve, also known as an EEG. Brain waves can be decomposed into waves ranging from small to large in frequency, which are collectively referred to as biological rhythm waves [ 21 ]. They could be classified with the frequency range as delta, theta, alpha, beta, and gamma rhythms [ 18 , 20 , 22 , 23 , 24 , 25 ].…”

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“…rTMS has applications in both diagnosis and therapy, aiding in the detection of motor abnormalities, assessment of cognitive processes, and treatment of conditions like chronic pain, depression, and movement disorders [ 13 , 14 ]. qEEG Lab: Quantitative EEG (qEEG) provides detailed insights into brain electrical activity, assisting in the diagnosis of conditions such as epilepsy, encephalopathy, dementia, and TBI [ 15 - 18 ]. Our qEEG lab also hosts the annual NeurotechEU Summer School of QEEG, training young doctors across Europe.…”

“…qEEG Lab: Quantitative EEG (qEEG) provides detailed insights into brain electrical activity, assisting in the diagnosis of conditions such as epilepsy, encephalopathy, dementia, and TBI [ 15 - 18 ]. Our qEEG lab also hosts the annual NeurotechEU Summer School of QEEG, training young doctors across Europe.…”