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Prognostic Value of EEG Microstates in Acute Stroke

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Abstract

Given the importance of neuronal plasticity in recovery from a stroke and the huge variability of recovery abilities in patients, we investigated neuronal activity in the acute phase to enhance information about the prognosis of recovery in the stabilized phase. We investigated the microstates in 47 patients who suffered a first-ever mono-lesional ischemic stroke in the middle cerebral artery territory and in 20 healthy control volunteers. Electroencephalographic (EEG) activity at rest with eyes closed was acquired between 2 and 10 days (T0) after ischemic attack. Objective criteria allowed for the selection of an optimal number of microstates. Clinical condition was quantified by the National Institute of Health Stroke Scale (NIHSS) both in acute (T0) and stabilized (T1, 5.4 ± 1.7 months) phases and Effective Recovery (ER) was calculated as (NIHSS(T1)-NIHSS(T0))/NIHSS(T0). The microstates A, B, C and D emerged as the most stable. In patients with a left lesion inducing a language impairment, microstate C topography differed from controls. Microstate D topography was different in patients with a right lesion inducing neglect symptoms. In patients, the C vs D microstate duration differed after both a left and a right lesion with respect to controls (C lower than D in left and D lower than C in right lesion). A preserved microstate B in acute phase correlated with a better effective recovery. A regression model indicated that the microstate B duration explained the 11% of ER variance. This first ever study of EEG microstates in acute stroke opens an interesting path to identify neuronal impairments with prognostic relevance, to develop enriched compensatory treatments to drive a better individual recovery.

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Acknowledgements

The research leading to these results has received funding from: (1) The Italian Ministry of Health, Cod. GR-2008-1138642; (2) PNR-CNR Aging Program 2012–2018; (3) FISM – Fondazione Italiana Sclerosi Multipla –Prot. N. 13/15/F14. The authors want to acknowledge Peter Angelo Taliaferro for language editing.

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Authors and Affiliations

  1. Department of Neuroscience, Imaging and Clinical Sciences, “Gabriele d’Annunzio” University of Chieti-Pescara, via dei Vestini 31, 66100, Chieti, Italy

    Filippo Zappasodi & Pierpaolo Croce

  2. Institute for Advanced Biomedical Technologies, “Gabriele d’Annunzio” University of Chieti-Pescara, Chieti, Italy

    Filippo Zappasodi & Pierpaolo Croce

  3. Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, AFaR Division, Rome, Italy

    Alessandro Giordani

  4. Clinical Neurology, Campus Biomedico University of Rome, Rome, Italy

    Giovanni Assenza

  5. Department of Geriatrics, Neurosciences & Orthopaedics, Institute of Neurology, Catholic University of Sacred Heart, Policlinic A. Gemelli Foundation, Rome, Italy

    Nadia M. Giannantoni, Paolo Profice, Giuseppe Granata & Paolo M. Rossini

  6. Laboratory of Electrophysiology for Translational neuroScience (LET’S) – ISTC – CNR, at Department of Neuroscience, Fatebenefratelli Hospital, Rome, Italy

    Nadia M. Giannantoni & Franca Tecchio

  7. IRCCS S. Raffaele-Pisana, Rome, Italy

    Paolo M. Rossini

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  1. Filippo Zappasodi
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  2. Pierpaolo Croce
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  3. Alessandro Giordani
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  4. Giovanni Assenza
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Correspondence to Filippo Zappasodi.

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Zappasodi, F., Croce, P., Giordani, A. et al. Prognostic Value of EEG Microstates in Acute Stroke. Brain Topogr 30, 698–710 (2017). https://doi.org/10.1007/s10548-017-0572-0

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