Department of Rehabilitation Medicine, College of Medicine, Chungnam National University Hospital, Daejeon, Korea.
Medicine (Baltimore). 2022 Dec 2;101(48):e31766. doi: 10.1097/MD.0000000000031766.
Cognitive impairment is observed in 12% to 56% of stroke patients, and screening for cognitive impairment is often complex and time-consuming, with results dependent on patient compliance. Therefore, there is a need for an objective method to assess cognitive impairment regardless of patient compliance. Objective evaluation methods include electroencephalogram (EEG) and event-related potential (ERP). This study was conducted to assess intra-tester reliability of resting EEG-based spectral features and auditory/visual P300 latency/amplitude in patients with subacute ischemic stroke. Twenty patients with subacute ischemic stroke were included in the study. The resting EEG and P300 wave using an auditory and visual oddball paradigm were measured at baseline and once again in 24 hours. The following electrode positions (10-20 system) were constantly recorded: F3 (Frontal), Fz, F4, C3 (Central), Cz, C4, P3 (Parietal), Pz, P4. DAR (delta/alpha ratio) and BSI (brain symmetry index) were determined using EEG data. F3 and F4, C3 and C4 and P3 and P4 were switched according to the stroke side and classified as affected hemisphere (AH) and unaffected hemisphere (UH) after the evaluation. In ERP, the amplitude and latency of P300 were obtained. In reliability analysis of EEG-based spectral characteristics, significant reliability was observed for DAR (ICC = 0.447), BSldir (ICC = 0.713) and BSIdirtheta (ICC = 0.724) (Table 4). DAR was showed a poor ICC level, and BSIdir and BSIdirtheta had a moderate ICC level. Visual P300 latency showed excellent intraclass correlation coefficient (ICC) in several montages (PUH = 0.972, Pz = 0.945). In 6 montages, auditory P300 latency was reliable, while in 9 montages, visual P300 latency was reliable. In 4 montages, auditory P300 amplitude was reliable, while visual P300 amplitude was reliable in 7. The visual P300 was more reliable than the auditory P300. The ICC values for P300 latency were greater than those for amplitude. Therefore, when ERP is performed on subacute stroke patients, visual has higher reliability than auditory.
认知障碍在 12% 至 56%的中风患者中观察到，对认知障碍的筛查通常很复杂且耗时，结果取决于患者的依从性。因此，需要一种客观的方法来评估认知障碍，而不受患者依从性的影响。客观评估方法包括脑电图（EEG）和事件相关电位（ERP）。本研究旨在评估亚急性缺血性中风患者静息 EEG 频谱特征和听觉/视觉 P300 潜伏期/振幅的测试者内可靠性。研究纳入了 20 例亚急性缺血性中风患者。在基线和 24 小时时，使用听觉和视觉 oddball 范式测量静息 EEG 和 P300 波。始终记录以下电极位置（10-20 系统）：F3（额叶）、Fz、F4、C3（中央）、Cz、C4、P3（顶叶）、Pz、P4。使用 EEG 数据确定 DAR（delta/alpha 比）和 BSI（大脑对称指数）。根据中风侧，F3 和 F4、C3 和 C4 以及 P3 和 P4 进行切换，并在评估后将其分类为受影响的半球（AH）和未受影响的半球（UH）。在 ERP 中，获得 P300 的振幅和潜伏期。在基于 EEG 的频谱特征的可靠性分析中，DAR（ICC=0.447）、BSIdir（ICC=0.713）和 BSIdirtheta（ICC=0.724）表现出显著的可靠性（表 4）。DAR 的 ICC 水平较差，BSIdir 和 BSIdirtheta 的 ICC 水平为中等。在几个导联中，视觉 P300 潜伏期显示出极好的组内相关系数（ICC）（PUH=0.972，Pz=0.945）。在 6 个导联中，听觉 P300 潜伏期是可靠的，而在 9 个导联中，视觉 P300 潜伏期是可靠的。在 4 个导联中，听觉 P300 振幅是可靠的，而在 7 个导联中，视觉 P300 振幅是可靠的。视觉 P300 比听觉 P300 更可靠。P300 潜伏期的 ICC 值大于振幅的 ICC 值。因此，在对亚急性中风患者进行 ERP 时，视觉比听觉具有更高的可靠性。
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