Work

The alpha-delta ratio as a novel neurophysiological biomarker for early prediction of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage

Year: 2026

Type: article

Abstract: Quantitative EEG (qEEG) features, particularly the Alpha/Delta Ratio (ADR), reflect cortical metabolic status and may predict Delayed Cerebral Ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). This retrospective study included 63 aSAH patients. Early background EEG segments were analyzed to extract the ADR and Asymmetry Index (ASI). We compared their predictive value against the modified Fisher (mFisher) score using multivariate logistic regression and ROC analysis. DCI occurred in 24 (38.1%) patients. In univariate analysis, the DCI group exhibited significantly lower baseline ADR (P < 0.001) and significantly higher ASI (P = 0.022). However, in the multivariate analysis, only a lower ADR emerged as the sole independent predictor of DCI, while both ASI and the mFisher score lost significance. The ADR achieved an AUC of 0.844, significantly outperforming the mFisher score (AUC = 0.613). An ADR cut-off of < 0.14 yielded a sensitivity of 96%, markedly superior to that of mFisher (46%). Decreased ADR is a robust, independent predictor of DCI, offering superior sensitivity compared to radiographic grading. An ADR < 0.14 serves as a critical early warning sign for impending ischemia.

Source: European journal of medical research

DOI: 10.1186/s40001-026-04597-1

Authors: Yunping Li, Yang Wang, Weimin Dai, Huayong Wu, Jin Wang, Bingjie Jiang

Institutions: Wenzhou Medical University, Quzhou City People's Hospital

Language: English

Topic: Intracranial Aneurysms: Treatment and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190