Assess the Correlation Between Electroencephalogram, National Institutes of Health Stroke Scale and Montreal Cognitive Assessment in Patients with Acute Ischemic Stroke View PDF

Mohammed Sami Abdlhasan Al-Gharbawi
Department Of Neurology, Al-Basrah Teaching Hospital, Basrah Health Directorate, Ministry Of Health, Basrah, Iraq

Published on: 2024-10-22

Abstract

Background: Stroke severity can be assessed by montreal cognitive assessment (MoCA) for the cognitive outcome and by the national institutes of health stroke scale (NIHSS) for the functional outcome. Moreover, quantitative electroencephalography (qEEG) can detect any subtle changes in brain metabolism which could be used for severity assessment. This study aimed to identify the association between qEEG with severity by NIHSS and MoCA in acute ischemic stroke.

Methods: A cross-sectional study recruited patients with acute ischemic stroke who were hospitalized at neurological ward. A total of 25 cases were investigated. All data were collected included age, sex, history of comorbidity, alberta stroke programme early CT score (ASPECTS), NIHSS, Indonesian version of MoCA (MoCA-Ina), and qEEG parameter. Initial stroke severity was assessed by NIHSS and MoCA-Ina. The qEEG parameters were shown in the form of absolute power.

Results: Most patients aged > 51 years, male more than female. There were no differences regarding age, sex, and ASPECTS based on NIHSS and MoCA-Ina score. However, cases with morbidity had lower median score of NIHSS than those without (p = 0.039). There were no differences in qEEG parameters based on NIHSS group. However, based on grouping of MoCA-Ina score, patients with cognitive impairment had higher δ-absolute power than those with normal cognitive functioning (p = 0.01). We found that δ-absolute power was independently associated with MoCA score, but not with NIHSS (p < 0.001).

Conclusions: qEEG parameters had significant correlation with initial stroke severity in acute ischemic stroke patients. δ-absolute power, and ratios negatively correlated with MOCA-Ina score. The use of qEEG for detecting initial stroke severity may help clinicians to plan better management to prevent the worsening outcome of stroke.

Keywords

Quantitative electroencephalography, National institutes of health stroke scale, Montreal cognitive assessment, Acute ischemic stroke, ?-absolute power

Introduction

Stroke severity at onset can affect outcomes, including mortality, treatment duration, stroke progression and functional healing [1]. It is a potential and significant outcome predictors improvement when stroke severity detecting as early as possible. Improvements in the assessment of initial stroke severity can result in more specific management of rehabilitation and can provide clearer data for cases and their families. Different previous studies used primer stroke assessments with the NIHSS as a predictor of neurological functional outcomes [2].

NIHSS has been validated and commonly used to measure both the initial stroke severity and the treatment outcomes [3]. Several scale items need intact language function, thus the NIHSS is overweight deficit in cases with left versus right brain strokes. Left hemisphere strokes score four more points than right hemisphere stroke of similar size [4].