卒中后急性期伴认知障碍的脑电图微状态研究OA

Objective To explore the underlying neuroelectrophysiological mechanisms in patients with acute post-stroke accompanying cognitive impairment(APSACI)and to identify the associated specific electroencephalography microstates. Methods Patients with acute ischemic stroke who were admitted to Tongzhou Campus of Dongzhimen Hospital,Beijing University of Chinese Medicine from October 1,2024 to June 30,2025 were consecutively enrolled.According to the MoCA score,patients were divided into two groups:those with a score ≥26 were assigned to the acute post-stroke non-cognitive impairment(APSNCI)group,and those with a score＜26 were assigned to the APSACI group.Resting-state electroencephalography data were collected to analyze temporal parameters of four typical microstates:duration,occurrence,coverage,and transition probability.Pearson correlation analysis was employed to investigate the associations between these temporal parameters and MoCA scores,and ROC curve analysis was adopted to verify the results with significant correlations. Results A total of 31 patients with acute ischemic stroke were enrolled in this study,including 14 cases in the APSNCI group(11 males and 3 females)and 17 cases in the APSACI group(13 males and 4 females).There were significant differences between the two groups in the duration of microstate C and D,as well as the occurrence and coverage of microstate D(all P＜0.05).After Bonferroni correction,the between-group difference in the duration of microstate D emained statistically significant(P=0.002).Significant differences were observed in the transition probabilities of microstate A→D,B→C,B→D,and D→B between the two groups(all P＜0.05).The duration,occurrence,and coverage of microstate D,as well as the transition probability of microstate D→B showed significant positive correlations with MoCA scores(all P＜0.05).The AUC values of duration-D and coverage-D were relatively high,while the AUC value of microstate D→B was relatively low. Conclusions Patients with APSACI exhibit specific large-scale brain network dysfunctions,particularly involving microstate C/D-related networks,as well as abnormalities in dynamic coordination.Parameters associated with microstate D show significant correlations with the severity of cognitive impairment.Electroencephalography microstate features could serve as potential biomarkers reflecting the neuroelectrophysiological mechanisms of APSACI and assessing its severity of cognitive impairment.These findings are helpful for understanding the pathological basis of APSACI and developing auxiliary diagnostic tools in the future.