1 Brain Injury Outcomes-The Johns Hopkins Medical Institutions , Baltimore, Maryland.
2 Department of Psychiatry, New York University School of Medicine , New York, New York.
J Neurotrauma. 2018 Jan 1;35(1):41-47. doi: 10.1089/neu.2017.5004. Epub 2017 Sep 21.
The potential clinical utility of a novel quantitative electroencephalographic (EEG)-based Brain Function Index (BFI) as a measure of the presence and severity of functional brain injury was studied as part of an independent prospective validation trial. The BFI was derived using quantitative EEG (QEEG) features associated with functional brain impairment reflecting current consensus on the physiology of concussive injury. Seven hundred and twenty adult patients (18-85 years of age) evaluated within 72 h of sustaining a closed head injury were enrolled at 11 U.S. emergency departments (EDs). Glasgow Coma Scale (GCS) score was 15 in 97%. Standard clinical evaluations were conducted and 5 to 10 min of EEG acquired from frontal locations. Clinical utility of the BFI was assessed for raw scores and percentile values. A multinomial logistic regression analysis demonstrated that the odds ratios (computed against controls) of the mild and moderate functionally impaired groups were significantly different from the odds ratio of the computed tomography (CT) postive (CT+, structural injury visible on CT) group (p = 0.0009 and p = 0.0026, respectively). However, no significant differences were observed between the odds ratios of the mild and moderately functionally impaired groups. Analysis of variance (ANOVA) demonstrated significant differences in BFI among normal (16.8%), mild TBI (mTBI)/concussed with mild or moderate functional impairment, (61.3%), and CT+ (21.9%) patients (p < 0.0001). Regression slopes of the odds ratios for likelihood of group membership suggest a relationship between the BFI and severity of impairment. Findings support the BFI as a quantitative marker of brain function impairment, which scaled with severity of functional impairment in mTBI patients. When integrated into the clinical assessment, the BFI has the potential to aid in early diagnosis and thereby potential to impact the sequelae of TBI by providing an objective marker that is available at the point of care, hand-held, non-invasive, and rapid to obtain.
作为一项独立的前瞻性验证试验的一部分，研究了一种新型基于定量脑电图（EEG）的脑功能指数（BFI）作为衡量功能性脑损伤存在和严重程度的潜在临床效用。BFI 是使用与反映震荡性损伤生理学共识的功能性脑损伤相关的定量 EEG（QEEG）特征得出的。在 11 个美国急诊部（ED），共招募了 720 名年龄在 18-85 岁之间的闭合性颅脑损伤后 72 小时内接受评估的成年患者。格拉斯哥昏迷量表（GCS）评分为 97%的 15 分。进行了标准临床评估，并从额区采集了 5 至 10 分钟的脑电图。评估了 BFI 的原始评分和百分位值的临床效用。多项逻辑回归分析表明，轻度和中度功能受损组的优势比（相对于对照组计算）与计算机断层扫描（CT）阳性（CT+，CT 上可见结构性损伤）组的优势比明显不同（p=0.0009 和 p=0.0026，分别）。然而，轻度和中度功能受损组之间的优势比没有观察到显著差异。方差分析（ANOVA）表明，正常（16.8%）、轻度创伤性脑损伤（mTBI）/轻度或中度功能受损（61.3%）和 CT+（21.9%）患者之间 BFI 存在显著差异（p<0.0001）。组内成员可能性的优势比回归斜率表明 BFI 与损伤严重程度之间存在关系。研究结果支持 BFI 作为脑功能损伤的定量标志物，可与 mTBI 患者的功能损伤严重程度相匹配。当整合到临床评估中时，BFI 具有通过提供可在护理点获得、手持、非侵入性和快速获得的客观标志物来辅助早期诊断并有可能影响 TBI 后果的潜力。
