{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:34:15Z","timestamp":1793144055767,"version":"4.5.0"},"reference-count":40,"publisher":"IMR Press","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"2022 Shaoxing Municipal Health and Wellness Science and Technology Plan Project","award":["2022KY113"],"award-info":[{"award-number":["2022KY113"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background: Timely and accurate assessment of the response to intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) is crucial for guiding subsequent interventions in acute ischemic stroke (AIS). Quantitative electroencephalography (qEEG) offers a real-time measure of cerebral function sensitive to ischemia. This study aimed to investigate the predictive value of ultra-early dynamic changes in qEEG parameters following thrombolysis and develop a predictive model for 24-hour clinical efficacy. Methods: We conducted a single-center retrospective analysis of 216 patients with AIS who received intravenous rt-PA at the Stroke Center of Xinchang Hospital Affiliated to Shaoxing University between January 2023 and December 2024. qEEG recordings were acquired immediately before (T0) and 1 hour after the initiation of rt-PA infusion (T1). The primary qEEG parameter was the Delta-Theta\/Alpha-Beta Ratio (DTABR). We calculated the DTABR reduction value (T0 DTABR\u2013T1 DTABR) to quantify early neurophysiological improvement. The primary outcome was early clinical efficacy at 24 hours, defined as a reduction of \u22654 points in the National Institutes of Health Stroke Scale (NIHSS) score or an NIHSS score of 0\u20131. The cohort was randomized (7:3) into training (n = 151) and validation (n = 65) sets. A nomogram was constructed based on multivariate logistic regression. Model performance was evaluated using the area under the curve (AUC), calibration plots with the Hosmer\u2013Lemeshow test, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) analysis was employed for model interpretation. Results: Early clinical efficacy was achieved in 53.7% of patients. The DTABR reduction value was significantly higher in responders compared to non-responders (median 1.20 vs. 0.20, p &lt; 0.001). In the multivariate analysis, the DTABR reduction value emerged as a strong independent predictor of favorable outcomes (adjusted odds ratio [OR] = 2.745, 95% confidence interval [CI]: 1.283\u20135.870, p = 0.009). A nomogram integrating this dynamic qEEG marker with clinical variables (age, diabetes, onset-to-needle time, baseline diastolic blood pressure, baseline glucose, baseline NIHSS) demonstrated good discriminative ability, with an AUC of 0.77 (95% CI: 0.70\u20130.85) in the training set and 0.77 (95% CI: 0.65\u20130.88) in the validation set. The model exhibited excellent calibration and provided significant net clinical benefit across a wide range of threshold probabilities in the DCA. SHAP analysis identified the DTABR reduction value as the most influential feature. Conclusion: The magnitude of DTABR reduction within 1 hour of initiating intravenous thrombolysis is a robust, independent biomarker for early neurophysiological recovery. The developed nomogram offers a validated tool for real-time, individualized prediction of early treatment efficacy, potentially facilitating timely optimization of management strategies for AIS.<\/jats:p>","DOI":"10.31083\/bjhm54931","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T10:55:28Z","timestamp":1783421728000},"source":"Crossref","is-referenced-by-count":1,"title":["Early Quantitative Electroencephalography Parameters Predicting Clinical Outcomes of Intravenous rt-PA Thrombolysis in Acute Ischemic Stroke: A Retrospective Cohort Study"],"prefix":"10.31083","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5669-503X","authenticated-orcid":true,"given":"Hangtian","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Neurology, Xinchang Hospital Affiliated to Shaoxing University, 312500 Shaoxing, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4759-6902","authenticated-orcid":true,"given":"Yangchun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Xinchang Hospital Affiliated to Shaoxing University, 312500 Shaoxing, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. 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