Visual and spectral EEG analysis in the evaluation of the outcome in patients with ischemic brain infarction

Sainio, Kimmo; Stenberg, Dag; Keskimäki, Ilmo; Muuronen, Antti; Kaste, Markku

doi:10.1016/0013-4694(83)90066-4

Cited by 90 publications

(51 citation statements)

References 11 publications

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“…Various parameters have been proposed to quantify EEG changes in cerebral ischemia, varying from spectral EEG measures 10,11,14,20 and changes in delta power 6 to nonlinear approaches, for instance, the time-dependent entropy. 3 Recently, we have introduced the BSI, which is shown to be very sensitive to detect EEG asymmetry, as may occur during carotid surgery.…”

Section: Discussionmentioning

confidence: 99%

Continuous Quantitative EEG Monitoring in Hemispheric Stroke Patients Using the Brain Symmetry Index

Putten¹,

Tavy²

2004

Stroke

192

120

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Background and Purpose— There is increased awareness that continuous brain monitoring might benefit neurological patients, because it may allow detection of derangement of brain function in a possible reversible state, allowing early intervention. Here, we explore if quantitative continuous electroencephalography (cEEG) monitoring is technically feasible and possibly clinically relevant in patients with acute ischemic hemispheric stroke. Materials— Twenty-one consecutive patients with an acute hemispheric stroke were monitored in our stroke unit, using cEEG for 12 to 24 hours on the day of admission. EEGs were quantified using a particular measure for symmetry, the brain symmetry index (BSI). This measure was subsequently correlated with the clinical condition of the patient using the National Institute of Health Stroke Scale (NIHSS). Results— cEEG was technically feasible. We found a most satisfying positive correlation between the BSI and the NIHSS, with ρ≈0.86 ( P <0.01). Conclusions— Technically, cEEG monitoring posed no major problems. It was found that the BSI correlates satisfactorily with the clinical neurological condition of our stroke patients. This suggests that the BSI can be used as a measure to monitor possible changes of brain function in this patient category.

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Section: Discussionmentioning

confidence: 99%

Continuous Quantitative EEG Monitoring in Hemispheric Stroke Patients Using the Brain Symmetry Index

Putten¹,

Tavy²

2004

Stroke

192

120

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“…Transient global cerebral ischemia was induced by an adapted Pulsinelli's "four-vessel occlusion model" [24,25]. Bilateral electrocoagulation of the vertebral arteries was immediately followed by temporary occlusion of both common carotid arteries by means of two nontraumatic vascular microclamps.…”

Section: Cerebral Ischemiamentioning

confidence: 99%

Early electrocortical changes consistent with ischemic preconditioning in rat

Zagrean

Moldovan

Munteanu

et al. 2000

J Cellular Molecular Medi

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Ischemic preconditioning (IPC) of the brain describes the neuroprotection induced by a short, conditioning ischemic episode (CIE) to a subsequent severe (test) ischemic episode (TIE). Most of the supporting evidence for IPC is based on histological assessment, several days after TIE. The aim of this study is to investigate if changes induced by IPC can be detected within 30 min of reperfusion following the ischemic episode. A rat model of "four-vessel occlusion" transient global cerebral ischemia and parametric analysis of electrocorticogram were used. A control group was subjected directly to a 10 min TIE, and in a preconditioned group TIE was induced 48 h after a 3 min CIE. Quantitative histology was performed 48 h after TIE. Our key finding is that, 30 min after reperfusion, there is a significant increase in the electrocortical slow activity in the control group but not in the preconditioned group. Moreover the increase inversely correlates with the degree of electrocortical suppression during seconds 10 to 15 after the onset of the ischemic episode.The tolerance of the brain to an ischemic injury depends not only on the duration and severity of insufficient blood flow but also on various pre-and post-ischemic factors that are able to influence the post ischemic outcome. There is a lot of interest concerning the postischemic factors that can improve the recovery due to immediate clinical applicability. Nevertheless, recent experimental work focuses on the preischemic factors, that can increase the ischemic tolerance, among which the suppression of metabolic rate, the increase of brain tissue energy reserves and the inhibition of membrane permeability of cations are of particular importance [1].One of the most surprising discoveries in the search for preischemic neuroprotective factors was that exposure to short episodes of sublethal insults like ischemia, hypoxia, hyperthermic stresses and toxic agents results in a subsequent resistance to severe ischemic injury. The phenomenon of

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“…43 The coherence was calculated for the delta (0.1 to 4.0 Hz) and alpha (8.0 to 13.0 Hz) frequency bands because they are strong indicators for injury and recovery. 44,45 To limit intersubject variability, the coherence analysis was carried out relative to the baseline magnitude and by selecting 20 s of nonoverlapping artifact-free ECoG epochs from every 5 min of recordings. The coherence spectrum function, C xy ðfÞ, for two given signals is as follows:…”

Section: Data Analysis Of Electrophysiological Recordingsmentioning

confidence: 99%

Improving neurovascular outcomes with bilateral forepaw stimulation in a rat photothrombotic ischemic stroke model

et al. 2014

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Abstract. Restoring perfusion to the penumbra during the hyperacute phase of ischemic stroke is a key goal of neuroprotection. Thrombolysis is currently the only approved treatment for ischemic stroke. However, its use is limited by the narrow therapeutic window and side effect of bleeding. Therefore, other interventions are desired that could potentially increase the perfusion of the penumbra. Here, we hypothesized that bilateral peripheral electrical stimulation will improve cerebral perfusion and restore cortical neurovascular response. We assess the outcomes of bilateral forepaw electrical stimulation at intensities of 2 and 4 mA, administered either unilaterally or bilaterally. We developed a combined electrocorticogram (ECoG)-functional photoacoustic microscopy (fPAM) system to evaluate the relative changes in cerebral hemodynamic function and electrophysiologic response to acute, focal stroke. The fPAM system is used for cerebral blood volume (CBV) and hemoglobin oxygen saturation (SO 2 ) and the ECoG for neural activity, namely somatosensory-evoked potential (SSEP), interhemispheric coherence, and alpha-delta ratio (ADR) in response to forepaw stimulation. Our results confirmed the neuroprotective effect of bilateral forepaw stimulation at 2 mA as indicated by the 82% recovery of ADR and 95% improvement in perfusion into the region of penumbra. This experimental model can be used to study other potential interventions such as therapeutic hypertension and hypercarbia.

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Visual and spectral EEG analysis in the evaluation of the outcome in patients with ischemic brain infarction

Cited by 90 publications

References 11 publications

Continuous Quantitative EEG Monitoring in Hemispheric Stroke Patients Using the Brain Symmetry Index

Continuous Quantitative EEG Monitoring in Hemispheric Stroke Patients Using the Brain Symmetry Index

Early electrocortical changes consistent with ischemic preconditioning in rat

Improving neurovascular outcomes with bilateral forepaw stimulation in a rat photothrombotic ischemic stroke model

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