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CLINICAL TRIAL article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1509443
Exploring the Feasibility of EEG for Pre-Hospital Detection of Medium and Large Vessel Occlusion Strokes: A Proof-of-Concept Study
Provisionally accepted
William Peterson 1*
Nithya Ramakrishnan 1
David Tinklepaugh 1 Adrian Hamburger 1 Arthur Kowell 2 Krag Browder 1
Nerses Sanossian 3,4*
Peggy Nguyen 3
Ezekiel Fink 1*- 1 Asterion AI, Dallas, TX, United States
- 2 UCLA Health System, Los Angeles, California, United States
- 3 Keck School of Medicine, University of Southern California, Los Angeles, California, United States
- 4 Roxanna Todd Hodges Stroke Program, University of Southern California, Los Angeles, CA, United States
Early and accurate identification of stroke subtypes, particularly medium (MeVO) and large vessel occlusions (LVO), is critical for timely intervention and improving patient outcomes.Current pre-hospital diagnostic methods are limited in sensitivity, delaying treatment for ischemic stroke candidates eligible for endovascular thrombectomy (EVT). This proof-of-concept study explores the feasibility of using electroencephalography (EEG) as a diagnostic tool for pre-hospital detection of MeVO and LVO strokes. Conducted in the emergency department setting, this study assessed the efficacy of quantitative EEG biomarkers in differentiating MeVO/LVO-positive cases (n=4) from MeVO/LVO-negative cases (n=23). EEG data was acquired using both dry and wet electrode systems, with wet electrodes yielding lower attrition rates arising from superior signal quality. Findings from MeVO-and LVO-positive subjects revealed hemispheric asymmetry in delta and alpha frequency bands, particularly in frontal and temporal regions, as well as a global attenuation of power irrespective of the region of stroke. This study supports the potential of EEG for real-time, non-invasive stroke detection in pre-hospital and clinical environments, demonstrating the need for wet EEG systems for reliable signal acquisition. Future work aims to validate the use of EEG in the pre-hospital setting in an effort to facilitate rapid triage and reduce time to treatment for stroke patients.
Keywords: EEG, Stroke, Emergency care, prehospital / EMS, Large vessel occlusion (LVO)
Received: 11 Oct 2024; Accepted: 24 Feb 2025.
Copyright: © 2025 Peterson, Ramakrishnan, Tinklepaugh, Hamburger, Kowell, Browder, Sanossian, Nguyen and Fink. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
William Peterson, Asterion AI, Dallas, TX, United States
Nerses Sanossian, Keck School of Medicine, University of Southern California, Los Angeles, 90033, California, United States
Ezekiel Fink, Asterion AI, Dallas, TX, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.