Effect Of Enhanced External Counterpulsation On Intracranial Perfusion And EEG Signal In Patients With Ischemic Stroke

Purpose:To explore the effect of enhanced external counterpulsation on intracranial perfusion,EEG signal and prognosis in patients with acute ischemic stroke;To explore the correlation between quantitative electroencephalogram(QEEG)and MRI perfusion and scale score.Methods:Patients with acute ischemic stroke who were admitted to the Department of Neurology of the First Hospital of Qinhuangdao City from December 2021 to December 2022 with unilateral intracranial macrovascular stenosis were selected as the study objects.According to the doctors’ suggestions and patients’ wishes,they were divided into experimental group and control group.Both groups were given conventional drug treatment,while the experimental group was given external counterpulsation treatment.General data of the two groups were collected after admission.Before the experiment,the National Institutes of Health Stroke Scale(NIHSS)score,MRS Score,modified Barthel index,electroencephalogram(EEG)and cerebral nuclear magnetic perfusion examination were given to all patients.NIHSS score,quantitative electroencephalogram(DTABR,DAR)and nuclear magnetic perfusion(CBV,CBF,MTT,TTP)were evaluated after treatment.MRS Score and improved Barthel index were evaluated after 3 months.The effects of enhanced external counterpulsation on intracranial perfusion,EEG signal and prognosis of patients with acute ischemic stroke were evaluated through the changes of scores and examination indicators,and the correlation between EEG signal and nuclear magnetic perfusion and scale score was discussed.This prospective case-control study was approved by the Ethics Committee of the First Hospital of Qinhuangdao.Results:1.Baseline data:There was no significant difference between the two groups in gender,age,education level,BMI,smoking history,drinking history,hypertension,diabetes,cerebral infarction personal history,and white matter sparsity(P>0.05).2.Scale score:(1)NIHSS score: After treatment,the NIHSS scores of both groups decreased,and the decrease was more significant in the experimental group,with a statistically significant difference(P<0.05);(2)MRS score: After 3 months,both groups had a decrease in MRS,and the experimental group had a more significant decrease,with a statistically significant difference(P<0.05).(3)Improved Barthel index: After 3 months,both groups showed an increase in the improved Barthel index,and the experimental group showed a more significant increase,with a statistically significant difference(P<0.05).3.Brain perfusion: After treatment,the CBF and CBV of the experimental group and the control group increased,while the MTT and TTP were shortened,with statistical significance(P<0.05);Before the experiment,there was no statistically significant difference between the CBV,CBF,MTT,and TTP groups(P>0.05).After the experiment,there was a statistically significant difference between the MTT and TTP groups(P<0.05),and the experimental group shortened more significantly than the control group.4.Quantitative electroencephalogram:(1)Both groups showed a decrease in DAR and DTABR before and after treatment,with a more significant decrease in the EECP group(P<0.05).(2)The slow wave on the lesion side of cerebral infarction patients with unilateral arterial stenosis increased compared to the contralateral side,and the difference was statistically significant(P<0.05)5.Correlation analysis: Dual variable Pearson correlation analysis showed a positive correlation between DAR and MTT(rp=0.654,P<0.001);Bivariate Spearman correlation analysis showed a positive correlation between DAR and NIHSS(rs=0.367,P=0.002).6.Effectiveness and safety: the effective rate of the experimental group was 94.7%,and the effective rate of the control group was 84.8%.The difference between the groups was statistically significant(P<0.05),indicating that EECP was effective;There was no significant difference between the two groups in the incidence of adverse reactions and recurrence rate(P>0.05).EECP was safe and feasible.Conclusions:1.Enhanced external counterpulsation can increase the level of intracranial perfusion in patients with ischemic stroke,shortening the mean transit time(MTT)and peak time(TTP);The proportion of slow waves on the lesion side of unilateral large artery stenosis cerebral infarction is increased compared to the contralateral side,and EECP can reduce the proportion of intracranial slow waves;It can also reduce the degree of disability of patients,improve their daily living ability,and improve their prognosis,making it a safe and effective treatment method.2.The quantitative electroencephalogram index DAR is highly correlated with the index MTT in magnetic resonance perfusion,and also has a certain correlation with the NIHSS score.Moreover,the quantitative electroencephalogram is more convenient,economical,and can monitor the changes of patients’ condition in real time,with a high sensitivity,and is worth promoting in the aspect of stroke condition monitoring.