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Analysis of quantitative electroencephalography in acute ischemic stroke with impaired cognitive function: a case control study
Wafira N.U.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Cognitive impairment following acute ischemic stroke significantly impacts patients’ quality of life and healthcare outcomes. Standard cognitive screening tools are often limited by stroke-induced disabilities. Quantitative electroencephalography (QEEG) offers an alternative for assessing brain wave activity linked to cognitive function.METHODS: This observational case-control study compared QEEG parameters (delta, theta, alpha, beta, delta-alpha ratio [DAR], and delta-theta-alpha-beta ratio [DTABR]) between acute ischemic stroke patients with and without cognitive impairment. Conducted at Dr. Wahidin Sudirohusodo General Hospital, the study included 40 patients with stroke onset ≤7 days, assessed using the Montreal Cognitive Assessment Indonesian version (MoCA-Ina). QEEG recordings were analyzed using Neuroguide Deluxe software, and statistical correlations between QEEG parameters and MoCA-Ina scores were evaluated.RESULTS: Patients with cognitive impairment demonstrated increased delta and theta wave activity, particularly in the frontal leads, compared to those without impairment. Slow-wave dominance (higher DAR and DTABR) was observed in impaired patients, correlating with reduced MoCA-Ina scores (delta: r=−0.563; theta: r=−0.387). Conversely, fast waves (alpha and beta) showed no significant differences between groups. Median DTABR values were significantly higher in the cognitive impairment group, reflecting greater structural and functional brain damage.CONCLUSIONS: Delta, theta, DAR, and DTABR parameters may serve as biomarkers for early detection of cognitive impairment in acute ischemic stroke. QEEG is proposed as a feasible screening tool to improve prognosis and management, with further research needed to explore its role in predicting long-term cognitive outcomes.