Sampsa Lohi, Pekka Jäkälä, Jouni Kurola, Pasi Tuunanen, Susanna Westeren-Punnonen, Anu Muraja-Murro, Reetta Kälviäinen, Esa Mervaala
Abstract
Triaging acute ischemic stroke patients is difficult in prehospital settings. We investigated if a quickly applicable and compact EEG recording system is usable for stroke patients in the ambulance.
Introduction
Stroke is the third leading cause of mortality worldwide and the fourth most common cause of lost disability-adjusted life years [1]. In acute ischemic stroke, there is a limited window of opportunity to save a critically hypoperfused but still viable brain tissue through reperfusion, limiting the extent of the final infarct.
Materials and methods
BrainStatus, a disposable forehead electrode set [15,16], has been tested for use to exclude nonconvulsive status epilepticus in acute patients with altered mental states in Kuopio University Hospital [17].
Results
All but one recording contained mostly (i.e., for more than half of the recording) interpretable signal data. One recording suffered from significant artefacts from both the patient’s movements and failing electrode contacts; and due to its poor quality, it was excluded from the rest of the analysis.
Discussion
van Stigt et al. [13] have recently reported with a large patient population of 311 suspected stroke patients that prehospital EEG has high diagnostic accuracy. In this seminal study, however, the authors noted that EEG data suffered from insufficient quality thus preventing proper analysis in 32% of the patients.
Conclusions
Bittium BrainStatus, a CE-marked and commercially available compact EEG amplifier-recorder, is technically suitable for use in the ambulance. In our feasibility study the quality of the EEG signal was high and, at best, was sufficient for clinical decision-making.
Citation: Lohi S, Jäkälä P, Kurola J, Tuunanen P, Westeren-Punnonen S, Muraja-Murro A, et al. (2025) Feasibility of recording EEG in the ambulance using a portable, wireless EEG recording system. PLoS One 20(7): e0327415. https://doi.org/10.1371/journal.pone.0327415
Editor: Maria Nazarova, Aalto University School of Science and Technology: Aalto-yliopisto Insinooritieteiden korkeakoulu, FINLAND
Received: October 11, 2024; Accepted: June 13, 2025; Published: July 1, 2025
Copyright: © 2025 Lohi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data cannot be shared publicly because the patient consent form was designed and approved before a GDPR-related change in Finnish patient data legislation in 2019. Data are available from the Pohjois-Savon hyvinvointialue Ethics Committee (contact via tutkimuseettinentoimikunta@pshyvinvointialue.fi) for researchers who meet the criteria for access to confidential data.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
