Correlation between electroencephalogram reactivity and early neurological deficits in elderly acute cerebral infarction patients with cerebral microbleeds / 中华老年医学杂志

ABSTRACT

Objective:To analyze the relationship between electroencephalogram(EEG)reactivity and early neurological deficits in elderly acute cerebral infarction(ACI)patients with cerebral microbleeds.Methods:Clinical data were collected from 51 elderly ACI patients with cerebral microbleeds admitted to our hospital from July 2018 to April 2020, who formed the ACI with cerebral microbleeds group, and were retrospectively analyzed.The ACI group was composed of 47 patients with ACI treated at our hospital during the same period.All patients underwent EEG examination.EEG reactivity, sleep waves and other signs were monitored.Early neurological deficits were recorded 2 hours after thrombolysis in elderly ACI patients with cerebral microbleeds, assessed using the National Institutes of Health Stroke Scale(NIHSS), and divided into subgroups.Baseline data and EEG-related findings were compared between the two groups.The relationship between the severity of early neurological deficits and EEG reactivity was analyzed.Results:EEG reactivity and the positive detection rate for sleep waves were lower(33.33% or 17/51 vs.65.96% or 31/47, 27.45% or 14/51 vs.61.70% or 29/47, χ2=10.417 and 11.652, P=0.000 and 0.001)and early neurological deficits were more serious( Z=2.381, P=0.017)in the ACI with cerebral microbleeds group than in the ACI group.The proportions of cases with EEG reactivity and negative sleep waves were higher(91.18% or 31/34 vs.8.82% or 3/34, 86.49% or 32/37 vs.13.51% 5/37, χ2=17.771 and 13.147, both P=0.000)and the levels of vWF were lower(6.24±1.79 mg/L vs.13.48±2.23 mg/L, t=12.039, P=0.000)in elderly patients with moderate and severe ACI accompanied by cerebral microbleeds than in elderly patients with mild ACI accompanied by cerebral microbleeds.Logistic regression analysis showed that absence of EEG reactivity( OR=18.994, P=0.000), negative sleep waves( OR=11.520, P=0.001)and low levels of vWF( OR=0.283, P=0.001)were correlated with the degree of early neurological deficits in elderly ACI patients with cerebral microbleeds, with absence of EEG reactivity having the most significant impact.The results of receiver operating characteristic(ROC)curve showed that the area under the ROC curve(AUC)of absent EEG reactivity for predicting early moderate and severe neurological impairment was 0.803(95% CI 0.650-0.956, P<0.001), indicating a certain degree of predictive value. Conclusions:Elderly ACI patients with cerebral microbleeds are associated with different degrees of functional neurological deficits in early stages, and the degree of neurological deficits may be related to absence of EEG reactivity.In the future, EEG reactivity may be considered as a risk assessment tool for the progression of neurological deficits in elderly ACI patients with cerebral microbleeds.