TY - JOUR
T1 - Outcome prediction in acute monohemispheric stroke via magnetoencephalography
AU - Tecchio, Franca
AU - Pasqualetti, Patrizio
AU - Zappasodi, Filippo
AU - Tombini, Mario
AU - Lupoi, Domenico
AU - Vernieri, Fabrizio
AU - Rossini, Paolo Maria
PY - 2007/3
Y1 - 2007/3
N2 - Background: Following an ischemic stroke a highly variable clinical outcome is commonly evident despite similar onset symptoms as well as lesion characteristics. The aim of this study was to identify indexes providing early prediction of functional recovery, in addition to clinical severity and lesion dimension at onset of stroke. Methods: In 32 patients, magnetoencephalographic (MEG) parameters collected in the acute phase (<10 days from symptoms onset, T0) from affected (AH) and unaffected (UH) hemispheres at rest and evoked by sensory stimuli were evaluated in association with the clinical outcome in a stabilized phase (T1, median 7.8 months) classified with three levels: worsening, partial and full recovery. Results: Multiple multinomial logistic regression indicated AH gamma and UH delta band powers able to prognosticate clinical outcome at T1. After inclusion in this analysis, lesion volume had the strongest predictive ability, and UH delta band power remained as a predictive factor with a measurable cut-off, maximizing both sensitivity and specificity of the prediction: a patient with UH delta below cut-off would recover to some extent; a patient with UH delta above cut-off would have a probability of about 70% to worsen. Conclusions: MEG UH delta and AH gamma band powers were found to provide useful information about long-term outcome prognosis. Only the increase of delta band activity in the unaffected hemisphere contains information about the outcome in addition to the lesion volume.
AB - Background: Following an ischemic stroke a highly variable clinical outcome is commonly evident despite similar onset symptoms as well as lesion characteristics. The aim of this study was to identify indexes providing early prediction of functional recovery, in addition to clinical severity and lesion dimension at onset of stroke. Methods: In 32 patients, magnetoencephalographic (MEG) parameters collected in the acute phase (<10 days from symptoms onset, T0) from affected (AH) and unaffected (UH) hemispheres at rest and evoked by sensory stimuli were evaluated in association with the clinical outcome in a stabilized phase (T1, median 7.8 months) classified with three levels: worsening, partial and full recovery. Results: Multiple multinomial logistic regression indicated AH gamma and UH delta band powers able to prognosticate clinical outcome at T1. After inclusion in this analysis, lesion volume had the strongest predictive ability, and UH delta band power remained as a predictive factor with a measurable cut-off, maximizing both sensitivity and specificity of the prediction: a patient with UH delta below cut-off would recover to some extent; a patient with UH delta above cut-off would have a probability of about 70% to worsen. Conclusions: MEG UH delta and AH gamma band powers were found to provide useful information about long-term outcome prognosis. Only the increase of delta band activity in the unaffected hemisphere contains information about the outcome in addition to the lesion volume.
KW - Acute stroke
KW - Clinical outcome
KW - MEG
KW - Middle cerebral artery (MCA)
KW - Prognostic indications
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U2 - 10.1007/s00415-006-0355-0
DO - 10.1007/s00415-006-0355-0
M3 - Article
C2 - 17345051
AN - SCOPUS:33947147635
VL - 254
SP - 296
EP - 305
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
IS - 3
ER -