ArticleNeurology2023
Prehospital Detection of Large Vessel Occlusion Stroke With EEG.
Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03699397 (EEG Controlled Triage in the Ambulance for Acute Ischemic Stroke), which is not on this map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
EEG Controlled Triage in the Ambulance for Acute Ischemic Stroke
Who cites it
23 citing papers in PubMed, 33 citations in OpenAlex.
- Detection of early neurological deterioration using a quantitative electroencephalography system in patients with large vessel occlusion stroke after endovascular treatment.Journal of neurointerventional surgery · 2025Trial
- Review
- Diagnostic Accuracy of Lateral Flow Blood Tests to Detect Large Vessel Occlusion Stroke.Stroke (Hoboken, N.J.) · 2026Article
- Revolutionizing Pediatric Neurophysiology With Magnetoencephalography.Psychophysiology · 2026Review
- Current State of the Clinical Applications of Artificial Intelligence in Stroke: A Literature Review.Brain sciences · 2026Review
- Electroencephalography in stroke Care: From acute monitoring to Post-Stroke epilepsy.Clinical neurophysiology practice · 2026Review
- Electroencephalography (EEG) and Quantitative EEG for Acute Stroke Triage and Post-Reperfusion Monitoring: A Systematic Review.Archives of academic emergency medicine · 2026Review
- Machine learning enhanced noninvasive transcranial stroke detection using a portable eddy current damping sensor.iScience · 2025Article
- Postoperative electroencephalographic anterior asymmetry is associated with neurologic injury and increased morbidity.JTCVS open · 2025Article
- Stroke in pediatric ventricular assist device support.JHLT open · 2025Article
- EEG-Based Deep Learning Model for Hyper-Acute Large Vessel Occlusion Stroke Detection in Mice.CNS neuroscience & therapeutics · 2025Article
- A Decision-Analytic Model to Evaluate Cost-Effectiveness of Regional Implementation of a Mobile Stroke Unit.Neurology · 2025Article
- Point-of-Care Electroencephalography in Acute Neurological Care: A Narrative Review.Neurology international · 2025Review
- Mechanical thrombectomy for acute ischemic stroke after cardiac surgery or intervention: a retrospective cohort analysis.Frontiers in neurology · 2025Article
- A Clinical Model predicting the 90-Day Prognosis after Mechanical Thrombectomy in Patients with Acute Ischemic Stroke: A Retrospective Study.Current neurovascular research · 2025Article
- Feasibility of recording EEG in the ambulance using a portable, wireless EEG recording system.PloS one · 2025Article
- Evaluating the feasibility of prehospital point-of-care EEG: The prehospital implementation of rapid EEG (PHIRE) study.Journal of the American College of Emergency Physicians open · 2024Article
- Pre-Hospital Stroke Care beyond the MSU.Current neurology and neuroscience reports · 2024Review
- Journal Club: Prehospital Detection of Large Vessel Occlusion Stroke With Electroencephalography: Results of the ELECTRA-STROKE Study.Neurology · 2024Article
- Corrections to Received Date Information.Neurology · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
20 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesEndovascular thrombectomy (EVT) is standard treatment for anterior large vessel occlusion stroke (LVO-a stroke). Prehospital diagnosis of LVO-a stroke would reduce time to EVT by allowing direct transportation to an EVT-capable hospital. We aim to evaluate the diagnostic accuracy of dry electrode EEG for the detection of LVO-a stroke in the prehospital setting.
methodsELECTRA-STROKE was an investigator-initiated, prospective, multicenter, diagnostic study, performed in the prehospital setting. Adult patients were eligible if they had suspected stroke (as assessed by the attending ambulance nurse) and symptom onset <24 hours. A single dry electrode EEG recording (8 electrodes) was performed by ambulance personnel. Primary endpoint was the diagnostic accuracy of the theta/alpha frequency ratio for LVO-a stroke (intracranial ICA, A1, M1, or proximal M2 occlusion) detection among patients with EEG data of sufficient quality, expressed as the area under the receiver operating characteristic curve (AUC). Secondary endpoints were diagnostic accuracies of other EEG features quantifying frequency band power and the pairwise derived Brain Symmetry Index. Neuroimaging was assessed by a neuroradiologist blinded to EEG results.
resultsBetween August 2020 and September 2022, 311 patients were included. The median EEG duration time was 151 (interquartile range [IQR] 151-152) seconds. For 212/311 (68%) patients, EEG data were of sufficient quality for analysis. The median age was 74 (IQR 66-81) years, 90/212 (42%) were women, and the median baseline NIH Stroke Scale was 1 (IQR 0-4). Six (3%) patients had an LVO-a stroke, 109/212 (51%) had a non-LVO-a ischemic stroke, 32/212 (15%) had a transient ischemic attack, 8/212 (4%) had a hemorrhagic stroke, and 57/212 (27%) had a stroke mimic. AUC of the theta/alpha ratio was 0.80 (95% CI 0.58-1.00). Of the secondary endpoints, the pairwise derived Brain Symmetry Index in the delta frequency band had the highest diagnostic accuracy (AUC 0.91 [95% CI 0.73-1.00], sensitivity 80% [95% CI 38%-96%], specificity 93% [95% CI 88%-96%], positive likelihood ratio 11.0 [95% CI 5.5-21.7]). DISCUSSION: The data from this study suggest that dry electrode EEG has the potential to detect LVO-a stroke among patients with suspected stroke in the prehospital setting. Toward future implementation of EEG in prehospital stroke care, EEG data quality needs to be improved. TRIAL REGISTRATION INFORMATION: ClinicalTrials.gov identifier: NCT03699397. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that prehospital dry electrode scalp EEG accurately detects LVO-a stroke among patients with suspected acute stroke.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.