UKRAINS'KYI VISNYK PSYKHONEVROLOHII

The Scientific and Practical Journal of Medicine
ISSN 2079-0325(p)
DOI 10.36927/2079-0325

EEG-correlates of cerebral small vessel disease burden

Type of Article

In the Section

Index UDK:

Abstract

The development of methods of prevention of cerebral small vessel disease (cSVD) severe consequences, such as acute stroke, neurodegeneration and vascular dementia, requires defi ning of the most sensitive and stable indicators of cerebral circulation conditions, in particular, values of EEG parameters in a diff erent number/quality of brain asymptomatic lesions, by which the cSVD burden are determined.

To investigate cerebral electrogenic peculiarities in patients with a diff erent number/quality of MRI markers of cSVD, a prospective study of EEG parameters was performed in 40 patients (mean age 62.51 ± 1.38 years old) with MRI signs of cSVD and without history of stroke and in 10 patients (mean age 67.38 ± 3.85 years old) with a history of stroke (more than 2 years).

In patients with a high cSVD burden (4 points), all studied quantitative EEG characteristics were not only signifi cantly different from those in patients with a history of stroke, but rather resembled the stage preceding a symptomatic stroke. The growing of the cSVD burden was clearly refl ected in the values of δ- and α-indices correlating with the rate of cerebral blood fl ow. An increasing of the number of brain asymptomatic lesions was associated with a linear decreasing of spectral density of the α-band (r = –0.73). For each 1 point of increasing of cSVD burden, a decrease of α/δ-coeffi cient on average by 45 % (p < 0.001) occurred. There was a tendency of BSI increasing with an increase of a number of MRI-signs of the disease.

Although silent brain infarcts, white matter lesions, and cerebral microbleeds have no thunderous symptoms, during cSVD progress, morphostructural changes could result in worsening of brain functional conditions, in particular the bioelectric activity level, and this worsening could be as severe as one after a symptomatic stroke. Thus, the δ- and α-indices, as well as α/δ-ratio and spectral density of oscillations in the α-band, could be considered as EEG-correlates of the cSVD burden.

Pages

References

  1. Capillary dysfunction: its detection and causative role in dementias and stroke / L. Østergaard, S. N.  Jespersen, T.  S.  Engedal [et al.] // Curr. Neurol. Neurosci. Rep. 2015. Vol. 15, No. 6. P. 37.
  2. Сerebral small vessel disease: Capillary pathways to stroke and cognitive decline / L. Østergaard, T. S. Engedal, F. Moreton [et al.] // J. Cereb. Blood Flow Metab. 2016. Vol. 36, No. 2. P. 302—325.
  3. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden / J. Staals, S. D. Makin, F.  N. Doubal [et al.] // Neurology. 2014. Vol. 83, No. 14. P. 1228—1234.
  4. Cerebral atrophy in small vessel disease of the brain / TS Mishchenko, I. Nikishkova, V. Mishchenko, D. Kutikov // International Neurological Journal. 2016. № 8 (86). С. 13-19.
  5. Cognitive impairment in small vessel disease of the brain / TS Mishchenko, I. Nikishkova, V. Mishchenko, D. Kutikov // Ukrainian Journal of Psychoneurology. 2017. Vol. 25, No. 3 (92). С. 8-12.
  6. EEG in silent small vessel disease: sLORETA mapping reveals cortical sources of vascular cognitive impairment no dementia in the default mode network / R. V. Sheorajpanday, P. Marien, A. J. Weeren [et al.] // J. Clin. Neurophysiol. 2013. Vol. 30, No. 2. P. 178—187.
  7. Disturbed phase relations in white matter hyperintensity based vascular dementia: an EEG directed connectivity study / E. C. van Straaten, J. den Haan, H. de Waal [et al.] // Clin. Neurophysiol. 2015. Vol. 126, No. 3. P. 497—504.
  8. Nunez P. L., Srinivasan R., Fields R. D. EEG functional connectivity, axon delays and white matter disease // Clin. Neurophysiol. 2015. Vol. 126, No. 1. P. 110—120.
  9. Nikishkova IM, Mishchenko VM, Zabrodina LP. EEG signs of risk of symptomatic stroke in patients with multiple "silent" cerebral infarctions // International Neurol. 2016. № 3 (81). С. 118-122.
  10. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration / J.  M. Wardlaw, E.  E. Smith, G.  J. Biessels [et  al.]  // Lancet Neurol. 2013. Vol. 12. Р. 822—838.
  11. Rationale, design and methodology of the image analysis protocol for studies of patients with cerebral small vessel disease and mild stroke / M. del C. Valdés Hernández, P.  A. Armitage, M. J. Thrippleton [et al.] // Brain Behav. 2015. Vol. 5, No. 12. e00415.
  12. Application of diffusion tensor imaging parameters to detect change in longitudinal studies in cerebral small vessel disease  / E. A. Zeestraten, P. Benjamin, C. Lambert [et al.] // PLoSe One. 2016. Vol. 11, No. 1. e0147836.
  13. Progression of MRI markers in cerebral small vessel disease: sample size considerations for clinical trials  / Р. Benjamin, Е.  Zeestraten, С. Lambert [et  al.]  // J. Cereb. Blood Flow Metab. 2016. Vol. 36, No. 1. P. 228—240.
  14. American Clinical Neurophysiology Society Guideline 2—3 / J. N. Acharya, A.  J.  Hani, P.  D. Thirumala, T.  N. Tsuchida  // J. Clin. Neurophysiol. 2016. Vol. 33. P. 308—316.
  15. Handbook of ICU EEG monitoring / Ed. by Suzette M. LaRoche. New York : Demos Medical, 2013. 338 p.
  16. Foreman B., Classen J. Quantitative EEG for the detection of brain ischemia // Critical Care. 2012. Vol. 16, No. 2. P. 216—225.
  17. Additional value of quantitative EEG in acute anterior circulation syndrome of presumed ischemic origin / R. V. Sheorajpanday, G. Nagels, A. J. Weeren [et al.] // Clin Neurophysiol. 2010. Vol. 121, No. 10. Р. 1719—1725.
  18. Quantitative EEG in ischemic stroke: correlation with infarct volume and functional status in posterior circulation and lacunar syndromes  / R. V. Sheorajpanday, G. Nagels, A.  J. Weeren, P. P. De Deyn // Clin. Neurophysiol. 2011. Vol. 122, No. 5. P. 884—890.
  19. Van Putten M. J. A. M., Tavy D. L. J. Continuous quantitative EEG monitoring in hemispheric stroke patients using the Brain Symmetry Index // Stroke. 2004. No. 35. P. 2489—2492.
  20. Quantitative continuous EEG for detecting delayed cerebral ischemia in patients with poor-grade subarachnoid hemorrhage / J. Claassen, L. J. Hirsch, K. T. Kreiter [et  al.]  // Clin. Neurophysiol. 2004. Vol. 115. Р. 2699—2710.