AUTHOR=Tao Tao , Lu Shiqi , Hu Nan , Xu Dongyang , Xu Chenyang , Li Fajun , Wang Qin , Peng Yuan 

TITLE=Prognosis of comatose patients with reduced EEG montage by combining quantitative EEG features in various domains

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 17 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2023.1302318

DOI=10.3389/fnins.2023.1302318

ISSN=1662-453X

ABSTRACT=Objective: As the frontoparietal network underlies recovery from coma, a limited frontoparietal montage was used, and the prognostic values of EEG features for comatose patients were assessed.
Methods: Collected with a limited frontoparietal EEG montage, continuous EEG recordings of 81 comatose patients in ICU were used retrospectively. By 60-day Glasgow outcome scale (GOS), the patients were dichotomized into favourable and unfavourable outcome groups. Temporal-domain frequency-domain, and spatial-domain features were automatically extracted for comparison. Partial correlation analysis was applied to eliminate redundant factors and multiple correspondence analysis was used to explore discrimination between groups. Prognostic characteristics were calculated to assess the performances of EEG-feature-based predictors established by logistic regression. Analyses were performed on all patients, strokes subgroup, and traumatic brain injury (TBI) subgroup.
Results: By analysis on all patients, raised burst suppression ratio (BSR), suppressed root mean square (RMS), raised power ratio of β to α rhythm (β/α), and suppressed phase-lag index between F3 and P4 (PLI (F3, P4)) were associated with unfavourable outcome, and yielded AUC of 0.790, 0.811, 0.722, and 0.844, respectively. For strokes subgroup the significant variables were BSR, RMS, θ/total, θ/δ, and PLI (F3, P4), while for TBI subgroup only PLI (F3, P4) was significant. BSR combined with PLI (F3, P4) gave the best predictor by cross-validation analysis on all-patients group (AUC = 0.889, 95% CI: 0.819-0.960).
Conclusions: Features extracted from limited frontoparietal montage EEG served as valuable coma prognostic tools, where PLI (F3, P4) was always significant. Combining PLI (F3, P4) with features in other domains may achieve better performance.
Significance: A limited montage EEG coupled with an automated algorithm is valuable for coma prognosis.