AUTHOR=Peterson William , Ramakrishnan Nithya , Tinklepaugh David , Hamburger Adrian , Kowell Arthur , Browder Krag , Sanossian Nerses , Nguyen Peggy , Fink Ezekiel 

TITLE=Exploring the feasibility of EEG for pre-hospital detection of medium and large vessel occlusion strokes: a proof-of-concept study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1509443

DOI=10.3389/fneur.2025.1509443

ISSN=1664-2295

ABSTRACT=IntroductionEarly and accurate identification of stroke subtypes, particularly medium (MeVO) and large vessel occlusions (LVO), is critical for timely intervention and improving patient outcomes. Current pre-hospital diagnostic methods are limited in sensitivity, delaying treatment for ischemic stroke candidates eligible for endovascular thrombectomy (EVT).MethodsThis proof-of-concept study explores the feasibility of using electroencephalography (EEG) as a diagnostic tool for pre-hospital detection of MeVO and LVO strokes. Conducted in the emergency department setting, this study assessed the efficacy of quantitative EEG biomarkers in differentiating MeVO/LVO-positive cases (n = 4) from MeVO/LVO-negative cases (n = 23). EEG data was acquired using both dry and wet electrode systems, with wet electrodes yielding lower attrition rates arising from superior signal quality.ResultsFindings from MeVO- and LVO-positive subjects revealed hemispheric asymmetry in delta and alpha frequency bands, particularly in frontal and temporal regions, as well as a global attenuation of power irrespective of the region of stroke.DiscussionThis study supports the potential of EEG for real-time, non-invasive stroke detection in pre-hospital and clinical environments, demonstrating the need for wet EEG systems for reliable signal acquisition. Future work aims to validate the use of EEG in the pre-hospital setting in an effort to facilitate rapid triage and reduce time to treatment for stroke patients.