Is Resting-State EEG Longitudinally Associated With Recovery of Clinical Neurological Impairments Early Poststroke? A Prospective Cohort Study

Mique Saes, Sarah B. Zandvliet, Aukje S. Andringa, Andreas Daffertshofer, Jos W.R. Twisk, Carel G.M. Meskers, Erwin E.H. van Wegen, Gert Kwakkel*

*Corresponding author for this work

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Abstract

Background. The time course of cortical activation and its relation with clinical measures may elucidate mechanisms underlying spontaneous neurobiological recovery after stroke. Objective. We aimed to investigate (1) the time course of cortical activation as revealed by EEG-based spectral characteristics during awake rest and (2) the development of these spectral characteristics in relation to global neurological and upper-limb motor recovery in the first 6 months poststroke. Methods. Resting-state EEG was measured serially in 41 patients after a first-ever ischemic stroke, within 3 and at 5, 12, and 26 weeks poststroke. We computed the brain symmetry index (BSI) and directional BSI (BSIdir) over different frequency bands (1-25 Hz, delta, theta) and delta/alpha ratio (DAR). The National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer motor assessment of the upper extremity (FM-UE) were determined as clinical reflections of spontaneous neurobiological recovery. Longitudinal changes in spectral characteristics and within- and between-subject associations with NIHSS and FM-UE were analyzed with linear mixed models. Results. Spectral characteristics showed a gradual normalization over time, within and beyond 12 weeks poststroke. Significant within- and between-subject associations with NIHSS were found for DAR of the affected hemisphere (DARAH) and BSIdirdelta. BSIdirdelta also demonstrated significant within- and between-subject associations with FM-UE. Conclusions. Changes in spectral characteristics are not restricted to the time window of recovery of clinical neurological impairments. The present study suggests that decreasing DARAH and BSIdirdelta reflect improvement of global neurological impairments, whereas BSIdirdelta was also specifically associated with upper-limb motor recovery early poststroke.

Original languageEnglish
Pages (from-to)389-402
Number of pages14
JournalNeurorehabilitation and Neural Repair
Volume34
Issue number5
Early online date4 Apr 2020
DOIs
Publication statusPublished - May 2020

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the European Research Council under the European Union’s Seventh Framework Programme (FP/2007–2013 ERC Grant Agreement n. 291339, project “4DEEG: A New Tool to Investigate the Spatial and Temporal Activity Patterns in the Brain”), as well as by the Dutch Brain Foundation (F2011(1)-25) and the Netherlands Organization of Scientific Research (research programme NeuroCIMT, project number 14905). Sponsors had no other involvement than financial support.

FundersFunder number
Dutch Brain FoundationF2011(1)-25
Netherlands Organization of Scientific Research
Northwestern University
Seventh Framework Programme291339
European Research Council
Technische Universiteit Delft
Nederlandse Organisatie voor Wetenschappelijk Onderzoek14905
Seventh Framework Programme

    Keywords

    • biomarker
    • EEG
    • longitudinal study
    • recovery of function
    • stroke
    • upper extremity

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