Quantitative electroencephalogram characteristics and their correlation with early cognitive impairment in patients with acute cerebral infarction

Xu Liang; Zhu Qing; Yao Yulan; Zhu Yuan; Li Wenlei; Li Zeyi; Liu Shen; Wu Minghua

doi:10.3969/j.issn.1672-5921.2026.01.003

Abstract：Objective To explore the characteristics of quantitative electroencephalogram(QEEG)and their correlation with early cognitive impairment in patients with acute cerebral infarction.Methods Patients with acute cerebral infarction in the Department of Neurology,Affiliated Hospital of Nanjing University of Chinese Medicine from January 2022 to December 2024 were prospectively and consecutively enrolled.General and clinical data were collected,including age,sex,history of hypertension,diabetes,coronary heart disease,admission National Institutes of Health stroke scale(NIHSS)score,and educational years.Patients were divided into a cognitive impairment(Montreal cognitive assessment[MoCA]scale score＜26)group and a non-cognitive impairment(MoCA scale score≥26)group based on their MoCA scale scores on the 2nd day after admission,with adjustments for educational years.QEEG parameters were collected and quantitatively analyzed on the 2nd day after admission,including the absolute power of α,θ,β,and δ waves,frontal-δ/α absolute power ratio(F-DAR),frontal-(δ+θ)/(α+β)absolute power ratio(F-DTABR),posterior-δ/α absolute power ratio(P-DAR)and posterior-(δ+θ)/(α+β)absolute power ratio(P-DTABR).Pearson correlation analysis was used to evaluate the correlation between QEEG parameters and MoCA scale scores,with|r|≥0.7 and＜0.9 indicating a high correlation,and|r|≥0.9 and＜1.0 indicating an extremely high correlation.Receiver operating characteristic(ROC)curves were used to assess the diagnostic value of composite QEEG parameters with high and extremely high correlation to MoCA scale scores for early cognitive impairment in patients with acute cerebral infarction.Results A total of 60 patients with acute cerebral infarction were included,including 49 males and 11 females,aged 30-79 years,with mean age of(62±11)years.Among them,30 patients were in the cognitive impairment group and 30 patients in the non-cognitive impairment group.(1)Compared with the non-cognitive impairment group,the cognitive impairment group had shorter educational years([10.47±3.06]years vs.[15.07±4.36]years)and higher admission NIHSS scores([13.30±2.59]points vs.[8.80±1.99]points;both P＜0.01),while no significant differences were observed in other general and clinical data between the two groups(all P＞0.05).(2)Compared with the non-cognitive impairment group,the cognitive impairment group had lower α absolute power([6.35±0.41]μV2 vs.[7.70±0.39]μV2,P＜0.01),and higher θ absolute power([14.72±0.85]μV2 vs.[13.13±0.34]μV2),δ absolute power([25.38±2.03]μV2 vs.[23.28±3.87]μV2),F-DAR(3.94±0.47 vs.2.95±0.51),P-DAR(4.10±0.60 vs.3.28±0.49),F-DTABR(3.83±0.30 vs.3.01±0.47),and P-DTABR(3.94±0.35 vs.3.22±0.33;all P＜0.05).(3)Pearson correlation analysis showed that α absolute power was positively correlated with MoCA scale scores(r=0.790),while θ absolute power(r=-0.787),δ absolute power(r=-0.351),F-DAR(r=-0.726),P-DAR(r=-0.509),F-DTABR(r=-0.758),and P-DTABR(r=-0.654)were negatively correlated with MoCA scale scores(all P＜0.01,all adjusted P＜0.008).Among these,α absolute power,θ absolute power,F-DAR,and F-DTABR showed a high correlation with MoCA scale scores.(4)ROC curve analysis showed that the area under the curve(AUC)of F-DAR for diagnosing early cognitive impairment after acute cerebral infarction was 0.912(95%CI 0.844-0.981),with a sensitivity of 1.00,specificity of 0.67,and optimal cutoff value of 3.03.For F-DTABR,the AUC was 0.933(95%CI 0.876-0.990),with a sensitivity of 0.87,specificity of 0.80,and optimal cutoff value of 3.47.The combined diagnosis of F-DAR and F-DTABR yielded an AUC of 0.949(95%CI 0.895-1.000),with a sensitivity of 0.97 and specificity of 0.80.Conclusion The characteristic indicators in QEEG can provide important objective evidence for the evaluation of early cognitive impairment after acute cerebral infarction.