Wednesday, February 6, 2019

Abstract TMP46: EEG is a Useful Biomarker of Motor Recovery in Early Stroke Rehabilitation

Dammit, stop trying to predict recovery and just provide the means to get there. Survivors don't give a damn about predictions, they want recovery. Have you never talked to any survivor? 

Abstract TMP46: EEG is a Useful Biomarker of Motor Recovery in Early Stroke Rehabilitation

Originally publishedhttps://doi.org/10.1161/str.50.suppl_1.TMP46Stroke. 2019;50:ATMP46
Introduction: The application of biomarkers to study and monitor stroke recovery mechanisms can potentially advance rehabilitation practice and research. This study examined the utility of dense-array electroencephalography (EEG) for predicting and capturing changes in brain function in early stroke rehabilitation.
Hypothesis: Changes in EEG measures involving ipsi- and contralesional motor cortices (iM1 and cM1) in delta (1-3Hz) and high beta (20-30Hz) frequency bands [1] parallel and [2] predict motor recovery.
Methods: Individuals with recent ischemic or hemorrhagic stroke admitted to an inpatient rehabilitation facility (IRF) completed a 3-minute resting-state EEG recording and behavioral testing (Upper Extremity Fugl-Meyer (FM) and Functional Independence Measurement motor subscale (FIM-motor)) during hospitalization and 90-days post-stroke. EEG power and coherence (connectivity) measures were computed from leads overlying iM1 and cM1.
Results: Twenty-seven subjects (20 males, age 58.3±14.6 years, 14.7±12.8 days post-stroke) participated. Greater decrease in iM1-cM1 coherence in the delta band correlated significantly with larger (a) FIM-motor score improvement from IRF admission to discharge (r=-0.70, p=0.001, n=18) and (b) FM score improvement from IRF admission to 90-days post-stroke (r=-0.57, p=0.02, n=17). Baseline EEG measures did not predict motor recovery when examined across the entire group. Performance of biomarkers varies according to stroke severity, and so prediction was further examined in relation to baseline FM. In subjects with moderate-severe impairment (FM≤40), delta iM1-cM1 coherence at baseline correlated with FIM-motor gains (r=0.72, p=0.03, n=9), and delta power in leads over iM1 positively correlated with FM gains (a) from IRF admission to discharge (r=0.75, p=0.03, n=8) and (b) from IRF admission to 90-days post-stroke (r=0.73, p=0.04, n=8).
Conclusions: Bedside EEG recording in the IRF provides neurophysiological insights that predict and parallel motor recovery, and so may be a valuable bedside tool in early stroke rehabilitation. EEG measures can predict motor recovery in individuals with moderate-severe motor impairment.

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