Sainio 1983 [40]
|
Admission and 7-day disability
|
15 Ischaemic Stroke patients
|
TIA
|
< 48
|
16 electrodes, eyes closed with checking for wakefulness.
|
Online only, > 30Hz, time constant 0.3s, sampling 100Hz
|
Relative spectral power (all bands), focal and background slowing
|
Poorer admission outcome associated with background (p = 0.00016) and focal (p = 0.0099) abnormalities, greater ipsilesional rolandic and occipital delta2 (p’s = 0.005) and less ipsilesional rolandic and occipital alpha (p = 0.005 and p = 0.025 respectively). Poorer 7-day outcome associated with background abnormalities (p = 0.0089) greater ipsilesional (p = .025) and contralesional (p = 0.025) delta2 and less ipsilesional alpha (p = 0.025).
|
4
|
Charlin 2000 [41]
|
Day 90 mRS
|
47 Ischaemic Stroke Patients
|
Epilepsy, cirrhosis, cancer, pre-stroke dependence; sedatives.
|
< 24
|
16 electrodes
|
None
|
PLEDs plus and PLEDS proper
|
Worse outcome (mRS >/=3) associated with PLEDs (p = 0.03, AUC = 0.62, sensitivity = 30.8%, specificity = 93.75%). (prognostic accuracy extrapolated from true and false positive and negative values)
|
3
|
Cuspineda 2003 [50]*
|
mRS at discharge and within three months
|
28 Ischaemic Stroke patients (MCA territory)
|
Haemorrhage
|
< 72
|
19 electrodes, awake, eyes open and closed, reclining, temperature controlled.
|
Online filters 0.3-30Hz, notch 60Hz, manual artifact removal, 2.56s epochs
|
Absolute spectral power (absolute energy)
|
Discharge and 3-month outcome (mRS) predicted by assessment of EEG absolute energy variables with 100% accuracy (r = 0.99). QEEG predicted outcome at discharge better than the CaNS (p = 0.03).
|
2
|
Cuspineda 2007 [46]*
|
mRS at discharge and within three months
|
28 Ischaemic Stroke patients (MCA territory)
|
Haemorrhage
|
< 72
|
19 electrodes, awake, eyes open and closed, reclining, temperature controlled.
|
Online filters 0.3-30Hz, notch 60Hz, manual artifact removal, 2.56s epochs
|
Absolute spectral power (all bands Absolute Energy)
|
Poorer outcome at discharge (mRS) predicted by.less alpha (Accuracy = 92.3% r = 0.95) and beta (Accuracy = 69.2%, r = 0.76) and greater theta (Accuracy = 92.3%, r = 0.94) and delta (Accuracy = 84.6%, r = 0.85) power within 24h. Poorer outcome at 3 months predicted by less alpha (Accuracy = 88.9%, r = 0.97) and beta (Accuracy = 77.8%, r = 0.83)and greater delta (Accuracy = 88.9%, r = 0.92, r 0.87) and theta (Accuracy = 77.8%, r = 0.83) within 24-48h.
|
4
|
Sheorajapanday 2011 [14]
|
Day 7 mRS
|
60 Ischaemic Stroke patients
|
Mass lesion; ICH; seizure(s); hypo/hyperglycaemia
|
Most < 72
|
19 electrodes, eye closed, awake/alert.
|
Online montage re-referencing; filters > 0.3Hz, </=30Hz, manual artifact removal, 128s epochs, FFT
|
Relative spectral power (DTABR), BSI
|
Greater DTABR predicted unfavourable outcome (mRS score > = 2) in LACS (AUC = 0.88; accuracy = 0.83%, p = 0.01) but not in POCS.
|
5
|
Su 2013 [42]
|
Three-month mRS
|
162 Ischaemic Stroke patients (large MCA infarct)
|
Pre-stroke dependence, concurrent illness affecting outcome, sedatives; extraneous factors affecting consciousness.
|
< 72
|
8 electrodes; pain and auditory stimulation
|
Online filter 0.5-70Hz, time constant 0.3ms
|
Dominant fast/slow wave with/without reactivity, RAWOD, epileptiform activity, burst and general suppression; alpha/theta coma.
|
Significant associations between worse outcome (mRS > 4) and RAWOD (OR = 2.47, sensitivity = 37%, specificity = 85%) and good outcome and dominant alpha with reactivity (OR = .08, but poor sensitivity = 7.4%, specificity = 49.3%). All other markers had > 80% specificity but < 40% sensitivity in predicting poor outcome. Modified grading most accurate (Kappa = 0.61, p = 0.04, sensitivity = 77.9%, specificity = 89.6%, accuracy = 91.4%)
|
4
|
Lima 2017 [44]
|
Three-month mRS
|
157 Ischaemic Stroke patients (19 with seizures)
|
Previous seizures, debilitating neurological disorders, hypo/hyperglycaemia
|
< 45.5
|
19 electrodes
|
None
|
Epileptiform activity (IED and PP)
|
Worse outcome (mRS >/=3) associated with epileptiform activity (OR = 2.94, p = 0.001) but not when seizures excluded (OR = 2.13, p = 0.07). AUC = 0.60, sensitivity = 51.3%, specificity = 69%). (prognostic accuracy extrapolated from true and false positive and negative values)
|
4
|
Bentes 2017 [43]*
|
mRS (including mortality) at discharge and within 1 year
|
151 Ischaemic Stroke patients (ICA;
NIHSS 4–42)
|
Prestroke dependence, traumatic brain injury or surgery, hydrocephalus, history of epilepsy
|
< 72
|
64 electrodes, eyes open and closed, resting, hyperventilation and photic stimulation.
|
Not Reported
|
Asymmetry, Suppression, focal slow-waves, epileptiform activity; periodic discharges
|
Worse outcome (mRS >/=3) at discharge associated with EEG background (OR = 5.55, p = 0.002) slowing, asymmetry (OR = 11.91, p < 0.001) and periodic discharges (OR = 10.39, p = 0.027).
Worse outcome at 1 year predicted by background slowing (OR = 14.50, p < 0.001) and asymmetry (OR = 22.73, p > 0.001) and periodic discharges (OR = 14.1, p = 0.002). Clinical and radiological predictors plus background asymmetry (AUC = 0.91, sensitivity = 81.1%, specificity = 88.7%) was a better model than clinical data plus past seizures (AUC = 0.83, sensitivity = 72.1%, specificity = 77.5%), clinical (AUC = 0.82, sensitivity = 70.3%, specificity = 73.2%), asymmetry (AUC = 0.81, sensitivity = 72.7%, specificity = 89%) and past seizures (AUC = 0.59, sensitivity = 25.7%, specificity = 93.2%) in isolation. 12-month mortality associated with EEG acute symptomatic seizures (OR = 4.55, p = 0.015) and EEG suppression (OR = 7.48, p = 0.019). Clinical/radiological predictors plus EEG suppression (AUC = 0.84, sensitivity = 31.8%, specificity = 99.2%) were a better predictor than clinical data plus acute seizures (AUC = 0.82, sensitivity = 40.9%, specificity = 100%), and clinical data (AUC = 0.81, sensitivity = 22.7%, specificity = 98.4%), acute seizures (AUC = 0.64, sensitivity = 0%, specificity = 100%), and suppression (AUC = 0.61, sensitivity = 26.1%, specificity = 96.1%) in isolation.
|
5
|
Xin 2017 [49]
|
BI/mRS at 21 days
|
29 Ischaemic Stroke patients
|
TIA, ICH, previous stroke, cardiovascular disorders, traumatic brain injury, tumour, ‘serious disease’, pregnancy.
|
< 72
|
16 electrodes, <3h after meal; sedatives discontinued 3 days prior.
|
Online and offline, filters < 0.53Hz, > 50Hz. Sampling 100Hz, EOG, ECG, EMG, visual and wavelet transform artifact removal, 10s epochs
|
r-BSI
|
Worse outcome (lower BI and higher mRS) associated with higher r-BSI at admission (BI -2.070, P = 0.049, mRS 2.256, P = 0.033).
|
3
|
Bentes 2018 [45]*
|
mRS at discharge and one year
|
151 Ischaemic Stroke patients (ICA;
NIHSS 4–42)
|
Prestroke dependence, traumatic brain injury or surgery, hydrocephalus, history of epilepsy
|
< 72
|
64 electrodes, eyes open and closed, resting, hyperventilation and photic stimulation.
|
Offline filters </=0.5Hz, > 70Hz, notch 50Hz, manual and automatic artifact removal, 2.05s epochs; FFT
|
Absolute spectral power (all bands, DAR, DTABR); BSI
|
Worse outcome (mRS >/=3) associated with greater delta (discharge AUC = 0.812, OR = 125; 12 months AUC = 0.836, OR = 129.8), and DTABR (discharge AUC = 0.827, OR = 1.702; 12 months AUC = 0.859, OR = 1.668) and less alpha (discharge AUC = 0.814, OR = 0.221; 12 months AUC = 0.852, OR = 0.16) and beta (discharge AUC = 0.803, OR = 0.28; 12 months AUC = 0.829, OR = 0.28) power (all p > 0.001; theta not significant).
The best discharge models combined clinical/radiological predictors with background asymmetry (AUC = 0.831, sensitivity = 81.3%, specificity = 68%), DTABR (AUC = 0.827, sensitivity = 87.5%, specificity = 60%), alpha power (AUC = 0.756, sensitivity = 86.9%, specificity = 46.2%) and background slowing (AUC = 0.787, sensitivity = 82.3%, specificity = 60%).
The best 12-month models combined clinical/radiological predictors with background asymmetry (AUC = 0.89, sensitivity = 81.1%, specificity = 88.7%), background slowing (AUC = 0.866, sensitivity = 78.4%, specificity = 87.3%), DTABR (AUC = 0.859, sensitivity = 79.7%, specificity = 74.6%) and alpha (AUC = 0.852, sensitivity = 75.7%, specificity = 78.9%). Isolated clinical data, followed by DTABR and alpha were good predictors (AUC’s = 0.768–0.794, sensitivity = 70.1–76.6%, specificity = 64.4–71.8%) (all p > 0.001).
|
4
|
Kuznietsov 2018 [47]
|
21-day mRS
|
103 Ischaemic Stroke patients (supratentorial)
|
Cardiovascular or psychiatric disorders, traumatic brain injury, ICH, tumour, past seizure(s)
|
< 72
|
19 electrodes
|
Offline independent component analysis artifact removal, 60s epochs; FFT
|
Absolute and relative spectral power (All bands, RSRP; FORG; IHRA)
|
Worse outcome post-stroke (mRS) associated with higher RSRP of delta band in contralesional hemisphere > 18.4 % (OR = 1.31, p = 0.0004; AUC = 0.94, sensitivity = 87.0%, specificity = 87.7 %, p < 0.0001), lower FORG of alpha band in ipsilesional hemisphere > -0.066 (OR = 29.07, p = 0.0224; AUC = 0.74, sensitivity = 67.4 %, specificity = 70.0 %, p < 0.0001) and IHRA of alpha band ≤ -0.066 (OR = 0.01, p = 0.0402; AUC = 0.66, sensitivity = 60.9%, specificity = 70.2 %, p < 0.0039). No significant differences for other biomarkers.
|
3
|
Rogers 2020 [48]
|
30 and 90-Day mRS and mBI
|
12 Ischaemic Stroke patients,
4 Haemorrhagic Stroke patients
|
Neurological/psychiatric disorders
|
< 72
|
Single electrode at 10–20 FP1, eyes closed.
|
Online sampling and amplification, Offline filter 0.5-30Hz, manual and automatic artifact removal, 4s epochs; FFT
|
Absolute and relative spectral power (all bands, DAR, DTR, DTABR)
|
Only relative theta power significantly negatively correlated with mRS (30-day r=-0.54; 90-day r=-0.53) and positively with mBI (30-day r = 0.60; 90-day r = 0.45). Better outcome post-stroke (mBI>/=95; mRS</=1) associated with higher theta values > = 0.25 for 30-day mRS (AUC = 0.81, sensitivity = 71.4%, specificity = 88.9%, p = 0.04), mBI (AUC = 0.90, sensitivity = 83.3%, specificity = 90%, p < 0.01) and 90-day mBI (AUC = 0.82, sensitivity = 80%, specificity = 81.8%, p = 0.05) but not 90-day mRS (AUC = 0.75, sensitivity = 62.5%, specificity = 87.5%, p = 0.09). EEG theta power was a no more accurate predictor than NIHSS.
|
4
|
Juhasz 1997 [56]
|
Modified NIHSS at 1 month
|
40 Ischaemic
Stroke patients
|
Bilateral stroke
|
< 48
|
16 electrodes
|
Online filters </=0.3, > 30, 4s and 80s epochs, artifacts removed
|
Absolute spectral power (alpha, beta); APF
|
Worse outcome (NIHSS) post stroke significantly associated with > 0.5Hz difference in interhemispheric APF (p < 0.02).
|
3
|
Vespa 2003 [37]
|
< 72h NIHSS and GOS at discharge
|
46 Ischaemic Stroke patients, 63 Haemorrhagic Stroke patients
(NIHSS 8–42)
|
Traumatic haemorrhage, SAH, ICH; Brainstem stroke
|
< 24
|
14 electrodes
|
Online (hospital staff) or offline (EEG segment review or total power trend) seizure detection and classification (focal, hemispheric or generalised)
|
Epileptiform activity
|
EEG seizures showed no association with GOS 4–5 (p = 0.25) but differed significantly according to NIHSS < 72h (p = 0.05).
|
4
|
Finnigan 2004 [11]
|
30 Day NIHSS
|
11 Ischaemic stroke patients
|
Fever, encephalitis, seizures, ICH, non-cortical stroke, confounding neurological condition (e.g. previous stroke) or medication.
|
< 9
|
64(62) electrodes, alert or drowsy.
|
Online filter .01-100Hz, artifacts 0.2- 40Hz, automatic artifact removal, 4s epochs, sampling 500Hz, FFT .5-50Hz
|
Relative spectral power (aDCI)
|
Worse outcome (higher NIHSS) associated with greater aDCI (rho = 0.80, P < 0.01)
|
3
|
Finnigan 2007 [55]
|
30 Day NIHSS
|
13 Ischaemic Stroke patients
|
Fever, encephalitis, seizures, ICH, confounding neurological condition (e.g. previous stroke) or medication.
|
< 52
|
62 electrodes, alert or drowsy.
|
Online filter .01-100Hz, artifacts 0.2- 40Hz, EOG artifact removal, 4s epochs, sampling 500Hz, FFT .5-50Hz
|
Relative spectral power (delta, theta, alpha; beta); DAR
|
Worse outcome (NIHSS) was associated with greater DAR (r = 0.91, P < 0.001) and less relative alpha power (r = -0.82, P < 0.01). These correlations were also observed in a 19-channel subset.
|
3
|
Wolf 2016 [39]
|
Admission and discharge NIHSS
|
69 Ischaemic Stroke patients
|
Epileptic seizures
|
< 48
|
10–20 system
|
Not Reported
|
Epileptiform activity; focal slowing
|
Worse outcome post-stroke (deterioration of NIHSS > 3 points admission vs discharge) associated with generalised EEG slowing (p = 0.003).
|
2
|
Yang 2017 [23]
|
7, 14 & 90 Day NIHSS
|
86 Ischaemic Stroke patients (NIHSS 4–24)
|
Cardiovascular disorders, pregnancy
|
< 4.5
|
20 electrodes
|
Online filter .16-70Hz, sampling 250Hz, FFT
|
Relative spectral power (DAR, DTABR), BSI
|
Neurological improvement of patients post-thrombolysis (decrease in NIHSS by 8 points or return to normal) significantly associated with early decrease in BSI (2h), DAR (2h) and DTABR (24h) (both p < 0.01)
|
4
|
De Herdt 2018 [54]
|
Day 7 NIHSS
|
29 Ischaemic Stroke patients, 2 Haemorrhagic stroke patients
|
Not Reported
|
< 72
|
Not Reported
|
Not Reported
|
Epileptiform activity (spikes, spike-waves; seizure, PLEDs)
|
Epileptiform activity not associated with outcome, only useful for predicting seizure incidence (abstract only - no statistics provided).
|
2
|
Gur 1994 [52]
|
Dementia diagnosis, checked every 6 months for 2 years
|
199 Ischaemic Stroke patients
|
Cognitive impairment, TIA, ICH, previous stroke
|
< 48
|
18 electrodes
|
Not Reported
|
Abnormal EEG patterns, foci, background slowing
|
Worse outcome (development of dementia) associated with abnormal EEG (OR = 2.6, p = 0.003, AUC = 0.38, sensitivity = 63.4%, specificity = 12.2%) (prognostic accuracy extrapolated from true and false positive and negative values)
|
3
|
Wang 2013 [38]
|
MoCA at two weeks and 2 years
|
110 Ischaemic
Stroke patients
|
Cognitive impairment, psychiatric disorders, traumatic brain injury, tumour, infection, multi-infarct, systemic disease, psychoactive drug use.
|
< 10
|
16 electrodes
|
Sampling 250Hz, offline filter 0.5-50Hz, computer, visual and EOG artifact removal, 2s epochs,
|
Relative spectral power (beta only)
|
Significantly lower beta power with cognitive impairment and larger infarct size (P < 0.01). Sensitivity: 92.3% for predicting impairment and 93.3% for predicting normal cognition. Good concordance between MoCA scores and beta power (Kappa statistic = 0.851, p < 0.001).
|
3
|
Song 2015 [57]
|
MoCA (Beijing version) 11 months − 7 years
|
105 Ischaemic Stroke Patients
|
Cognitive impairment, psychiatric disorders, traumatic brain injury, tumour, infection, multi-infarct, systemic disease, psychoactive drug use.
|
< 12
|
16 electrodes, eyes closed with checking for wakefulness.
|
Online filter 0.5-50Hz, Offline 2 sec epochs, EOG artifact removal, FFT
|
Relative spectral power (all bands)
|
Worse outcome associated with high background rhythm frequency (HR = 14 (3.8, 41), P < 0.001) or greater median theta power (HR = 5 (1.4, 7.8), P = 0.002).
|
4
|
Aminov 2017 [24]
|
90 Day MoCA
|
15 Ischaemic Stroke patients, 4 Haemorrhagic Stroke patients
|
Neurological/psychiatric disorders, previous stroke
|
< 72
|
Single electrode at FP1, eyes closed.
|
Online filter 0.5-30Hz, manual artifact removal, 4s epochs; FFT
|
Relative spectral power (DAR, DTR)
|
Better outcome moderately correlated with higher relative theta power (r = 0.50, p = 0.01), lower DAR (r = -0.45, p = 0.03), DTR (r = -0.57, p = 0.01) and relative delta power (r = -0.47, p = 0.02).
|
4
|
Yan 2011 [35]
|
Mortality
|
22 Stroke patients
|
Not
Reported
|
< 48
|
16 electrodes, eyes closed, resting
|
Offline visual artifact removal followed by digital filter, 10s epochs. FFT
|
BBSI
|
BBSI > 0.082 predicted mortality with an accuracy of 86.36%.
|
2
|
Chen 2018 [32]
|
Mortality at Day 90
|
47 Haemorrhagic Stroke patients
|
Aneurysm, vascular malformation, traumatic head/brain injury, tumour, infection/encephalitis
|
< 59
|
16 electrodes, eyes closed and awake; supine.
|
Offline filters > 0.3, </=30Hz, artifacts removed. FFT
|
Relative spectral power delta, alpha, DAR, DTABR), BSI
|
Mortality at Day 90 was associated with higher DAR (OR 5.306, p = 0.008). AUC for TCD-QEEG(DAR) model = 0.949.
|
4
|
Jiang 2019 [53]
|
Mortality at discharge and six months
|
58 Ischaemic Stroke patients
|
Prestroke dependence, consciousness altering drugs, haemorrhage, tumour, encephalitis, epilepsy
|
< 72
|
16 electrodes
|
Online filters 0.5-30Hz and offline visual artifact rejection. FFT
|
Relative spectral power (All bands, DTABR), BSI
|
Mortality at discharge and six months post-stroke associated with greater contralateral electrode theta power >/=25.53 (discharge p = .038, accuracy = 68%, sensitivity = 69.2%, specificity = 66.7%), 6-month p = 0.026, accuracy = 64%, sensitivity = 45.2%, specificity = 94.7%). No other biomarkers significantly contributed to the model.
|
4
|