Frontiers in Neurology (Oct 2022)

ELECTRA-STROKE: Electroencephalography controlled triage in the ambulance for acute ischemic stroke—Study protocol for a diagnostic trial

  • Maritta N. van Stigt,
  • Maritta N. van Stigt,
  • Anita A. G. A. van de Munckhof,
  • Anita A. G. A. van de Munckhof,
  • Laura C. C. van Meenen,
  • Eva A. Groenendijk,
  • Eva A. Groenendijk,
  • Monique Theunissen,
  • Gaby Franschman,
  • Martin D. Smeekes,
  • Joffry A. F. van Grondelle,
  • Geertje Geuzebroek,
  • Arjen Siegers,
  • Henk A. Marquering,
  • Henk A. Marquering,
  • Charles B. L. M. Majoie,
  • Yvo B. W. E. M. Roos,
  • Johannes H. T. M. Koelman,
  • Wouter V. Potters,
  • Wouter V. Potters,
  • Jonathan M. Coutinho

DOI
https://doi.org/10.3389/fneur.2022.1018493
Journal volume & issue
Vol. 13

Abstract

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BackgroundEndovascular thrombectomy (EVT) is the standard treatment for large vessel occlusion stroke of the anterior circulation (LVO-a stroke). Approximately half of EVT-eligible patients are initially presented to hospitals that do not offer EVT. Subsequent inter-hospital transfer delays treatment, which negatively affects patients' prognosis. Prehospital identification of patients with LVO-a stroke would allow direct transportation of these patients to an EVT-capable center. Electroencephalography (EEG) may be suitable for this purpose because of its sensitivity to cerebral ischemia. The hypothesis of ELECTRA-STROKE is that dry electrode EEG is feasible for prehospital detection of LVO-a stroke.MethodsELECTRA-STROKE is an investigator-initiated, diagnostic study. EEG recordings will be performed in patients with a suspected stroke in the ambulance. The primary endpoint is the diagnostic accuracy of the theta/alpha ratio for the diagnosis of LVO-a stroke, expressed by the area under the receiver operating characteristic (ROC) curve. EEG recordings will be performed in 386 patients.DiscussionIf EEG can be used to identify LVO-a stroke patients with sufficiently high diagnostic accuracy, it may enable direct routing of these patients to an EVT-capable center, thereby reducing time-to-treatment and improving patient outcomes.Clinical trial registrationClinicalTrials.gov, identifier: NCT03699397.

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