Observational studyBrain and behavior2026
Quantitative EEG-Based Detection of Poststroke Delirium Endotypes and Their Association With Biomarkers of Inflammation.
Observational study in Brain and behavior, 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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7 authors.
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Abstract
background and purposePoststroke delirium (PSD) is common and prognostically relevant, yet under-detected. Mechanistic and biomarker research is constrained by reliance on an intermittently observed binary phenotype, while delirium reflects one severity level on a continuum of delirium-related encephalopathy. Quantitative EEG (qEEG) may capture encephalopathy endotypes more directly and enable severity-spectrum characterization.
methodsIn this prospective, single-center, observational cohort study, 87 consecutive patients with acute ischemic stroke or transient ischemic attack were assessed within 48 h using the Confusion Assessment Method (CAM). A 64-channel EEG was recorded at enrollment; spectral power (delta/theta/alpha/beta) and functional connectivity metrics (phase lag index; amplitude envelope correlation corrected [AECc]) were computed. Neuroinflammatory and systemic biomarkers were quantified from routine serum sampling in an exploratory, add-on subcohort (n = 31).
resultsPSD occurred in 28 of 87 (32%). PSD was characterized by spectral slowing and altered AECc. A multivariable qEEG model discriminated PSD with AUC = 0.892 (p < 0.001) and overall accuracy of 81.4% (non-delirium 89.8%, delirium 63.0%). In the paired EEG plus serum subset, nominal exploratory correlations between qEEG metrics and selected biomarkers suggested links between network dysfunction and inflammatory signaling, including inverse correlations of theta-band AECc with VILIP-1 (r = -0.454, p = 0.045) and CX3CL1 (r = -0.604, p = 0.005), whereas biomarker-phenotype associations were less consistent.
conclusionsqEEG connectivity provides an encephalopathy-proximal readout that can detect PSD and may characterize delirium-related endotypes beyond the intermittently observed clinical phenotype. Findings require validation in larger, multicenter cohorts.
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