ArticleIBRO neuroscience reports2026
A qEEG-based prognostic model for cognitive impairment after ischemic stroke: Development and internal validation.
Article in IBRO neuroscience reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Cognitive impairment is a frequent and disabling consequence of ischemic stroke, yet early prognostic tools are limited. Quantitative electroencephalography (qEEG) offers a portable, low-cost measure of post-stroke cortical dysfunction. We aimed to develop a prognostic model for six-month cognitive impairment after first-ever ischemic stroke. Methods: In this single-centre prospective cohort study, patients with first-ever supratentorial ischemic stroke (NIHSS < 15) were enrolled within 7 days of onset at a tertiary hospital in Vietnam. Resting-state 19-channel EEG and brain MRI were acquired at baseline. Four region-specific qEEG parameters were derived for five cortical regions and globally: Delta/Alpha Ratio (DAR), Delta-Theta/Alpha-Beta Ratio, Peak Alpha Frequency (PAF), and Dominant Frequency Variability. The primary outcome was cognitive impairment at six months (education-adjusted MoCA < 26). Predictors were selected by AIC-guided forward stepwise logistic regression. Internal validation used a selection-aware bootstrap (1000 replicates), with multiple imputation and sensitivity analyses. Reporting followed TRIPOD and STROBE guidelines. Results: The analytic cohort comprised 96 participants; 44 (46%) developed cognitive impairment at six months. Higher occipital DAR (OR 2.09, 95% CI 1.45-3.39), lower frontal PAF (OR 0.46, 95% CI 0.27-0.74), and education below high school (OR 7.16, 95% CI 1.89-34.18) increased risk of cognitive impairment. Infarct volume was associated univariably but did not survive multivariable selection. Apparent AUC was 0.937 (95% CI 0.890-0.984); optimism-corrected AUC was 0.891 (0.861-0.945), with good calibration (Brier score 0.098). Effects were preserved across multiple imputation and alternative MoCA cutoffs. Conclusions: In this single-centre development cohort, a parsimonious three-variable model combining occipital DAR, frontal PAF, and educational attainment showed good internal discrimination and calibration for six-month cognitive impairment after first-ever ischemic stroke. These variables should be regarded as candidate predictors rather than an established prognostic tool; external multicentre validation against clinically adjudicated endpoints is the necessary next step before any clinical interpretation.
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