Case report: electro-cortical network effects of an acute stroke revealed by High density-Electroencephalography

Elena Monai ^1,2 Brinda Sevak ^1,2 Klevest Gjini ² Lorenzo Pini ³ Giulio Tononi ¹ Aaron F Struck ^2,4 Melanie Boly ^1,2*

• ¹ Wisconsin Institute for Sleep and Consciousness, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, United States
• ² Department of Neurology, University of Wisconsin-Madison, Madison, United States
• ³ Padua Neuroscience Center, University of Padua, Padua, Veneto, Italy
• ⁴ William S. Middleton Memorial Veterans Hospital, United States Department of Veterans Affairs, Madison, Wisconsin, United States

Focal lesions such as a stroke can cause not only local effects, but also distant effects in anatomically intact regions. The impact of stroke lesions on brain networks has been mapped using neuroimaging techniques as functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI). In the present study, we established the feasibility of detecting network dysfunction at the electro-cortical level using High density-electroencephalography (Hd-EEG).We studied brain function using Hd-EEG in a patient with an acute left middle cerebral artery stroke. Slowing in the delta range was present beyond the ischemic focus, extending to the perilesional regions as well as distant regions. There was also delta connectivity in the stroke hemisphere with slowing affecting mainly distant regions that were interconnected with the site of the ischemic region (i.e., network-level diaschisis), although this was not statistically significant.This case study illustrates the feasibility of using Hd-EEG to map local and distant electrical activity consequences of an acute stroke on cortical functions. Such technique could be clinically useful to improve personalized stroke-network mapping in patients with acute cortical lesions.