Abstract
OBJECTIVE: To evaluate the clinical utility of P300 event-related potentials combined with video electroencephalography (VEEG) in assessing post-stroke cognitive impairment (PSCI) in patients with strokes affecting different brain regions. METHODS: Stroke patients treated at our hospital were enrolled as the observation group. Based on lesion location, stroke patients were categorized into four subgroups: frontal lobe (n = 59), temporal lobe (n = 47), basal ganglia (n = 73), and brainstem (n = 35). An additional 60 age-matched healthy individuals were recruited as controls. All participants underwent cognitive assessment using the Mini-Mental State Examination (MMSE), and P300 and VEEG evaluations. RESULTS: At 7 days, 1 month, 3 months, and 6 months post-treatment, MMSE scores in the observation group were significantly lower than those in the control group. Correlation analysis showed that, in the frontal- and temporal-lobe groups, P300 amplitude and VEEG α and β power at day 7 were positively correlated with MMSE scores at 6 months. In contrast, P300 latency and VEEG delta and θ power, slow-wave index, and δ/α ratio (DAR) at day 7 were negatively correlated with 6-month MMSE scores. In the basal ganglia group, day 7 P300 amplitude and VEEG α power were positively correlated with 6-month MMSE scores, whereas P300 latency, δ and θ power, and DAR were negatively correlated. In the brainstem group, P300 latency, δ power, and slow-wave index at day 7 were negatively correlated with MMSE scores at 6 months. Receiver operating characteristic (ROC) analysis demonstrated that P300 combined with VEEG predicted PSCI in the frontal lobe group with a sensitivity of 94.32%, specificity of 92.58%, and area under the curve (AUC) of 0.932 (95% CI: 0.900-0.967). For the temporal lobe group, sensitivity was 82.74%, specificity 79.27%, and AUC 0.864 (95% CI: 0.812-0.915). In the basal ganglia group, sensitivity and specificity were 78.24% and 76.12%, respectively (AUC = 0.789, 95% CI: 0.727-0.851). For the brainstem group, sensitivity was 72.78%, specificity 69.56%, and AUC 0.727 (95% CI: 0.661-0.803). CONCLUSIONS: The combination of P300 and VEEG is a valuable tool for the early screening of PSCI, particularly in patients with frontal- or temporal-lobe strokes, where it shows highly predictive sensitivity and specificity.