Zhang Zhe, Hasan Shafiul, Sadan Ofer, Rosenthal Eric S, Pu Yuehua, Wen Zhixuan, Fang Changgeng, Liu Xin, Duan Wanying, Liu Liping, Xiao Ran, Hu Xiao
Neurocritical Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119 South 4th Ring Rd W, Beijing, 100070, China.
Center for Data Science, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
Neurocrit Care. 2025 Jan 7. doi: 10.1007/s12028-024-02178-w.
Neurovascular coupling (NVC) refers to the process of aligning cerebral blood flow with neuronal metabolic demand. This study explores the potential of contralateral NVC-linking neural electrical activity on the stroke side with cerebral blood flow velocity (CBFV) on the contralesional side-as a marker of physiological function of the brain. Our aim was to examine the association between contralateral NVC and neurological outcomes in patients with ischemic stroke following endovascular thrombectomy.
We concurrently recorded the CBFVs of the middle cerebral arteries and electroencephalographic (EEG) signals of patients after endovascular thrombectomy. We employed phase-amplitude cross-frequency coupling to quantify the contralateral coupling between EEG activity on the stroke side and CBFV on the contralesional side. Key neurological outcomes were measured, including changes in National Institute of Health Stroke Scale (NIHSS) scores, infarct volume progression over 7 days, and modified Rankin Scale scores at 90 days.
A total of 52 study participants were enrolled in our study (mean age 61.5 ± 10.4 years; 90.4% male; median preprocedural NIHSS score 14 [interquartile range 10-17]). We successfully computed contralateral NVC in 48 study participants. A significant association emerged between contralateral coupling and improvements in NIHSS scores over 7 days (theta band, P = 0.030) and in infarct volume progression (delta band, P = 0.001; theta band, P = 0.013). Stronger contralateral NVC in the delta and theta bands correlated with better outcomes at 90 days (adjusted odds ratio for delta 7.53 [95% confidence interval 1.13-50.30], P = 0.037; adjusted odds ratio for theta 6.36 [95% confidence interval 1.09-37.01], P = 0.039).
A better contralateral coupling between stroke-side EEG and contralesional CBFV is associated with favorable neurological outcomes, suggesting that contralateral NVC analysis may aid in assessing brain function after recanalization. Replication with a deeper understanding of the mechanisms is needed before clinical translation.
神经血管耦合（NVC）是指使脑血流量与神经元代谢需求相匹配的过程。本研究探讨对侧NVC的潜力，即将中风侧的神经电活动与对侧脑血流速度（CBFV）相联系，以此作为脑生理功能的一个指标。我们的目的是研究血管内血栓切除术治疗后的缺血性中风患者对侧NVC与神经功能结局之间的关联。
我们同时记录了血管内血栓切除术后患者大脑中动脉的CBFV和脑电图（EEG）信号。我们采用相位-振幅交叉频率耦合来量化中风侧EEG活动与对侧CBFV之间的对侧耦合。测量关键的神经功能结局，包括美国国立卫生研究院卒中量表（NIHSS）评分的变化、7天内梗死体积的进展以及90天时的改良Rankin量表评分。
共有52名研究参与者纳入我们的研究（平均年龄61.5±10.4岁；90.4%为男性；术前NIHSS评分中位数为14[四分位间距10-17]）。我们在48名研究参与者中成功计算出对侧NVC。对侧耦合与7天内NIHSS评分的改善（θ频段，P = 0.030）以及梗死体积进展（δ频段，P = 0.001；θ频段，P = 0.013）之间存在显著关联。δ和θ频段更强的对侧NVC与90天时更好的结局相关（δ频段调整后的优势比为7.53[95%置信区间1.13-50.30]，P = 0.037；θ频段调整后的优势比为6.36[95%置信区间1.09-37.01]，P = 0.039）。
中风侧EEG与对侧CBFV之间更好的对侧耦合与良好的神经功能结局相关，这表明对侧NVC分析可能有助于评估再通后脑功能。在进行临床转化之前，需要更深入了解其机制并进行重复研究。
