Detection of Spreading Depolarization with Noninvasive Electroencephalography

WAVEFRONT, a noninvasive scalp EEG biomarker, detects spreading depolarizations with a mean cross-validated true positive rate of 97.3±1% and false positive rate of 6.0±0.5% in TBI/SAH/MHS patients.

• Why it matters: Invasive subdural ECoG limits SD monitoring to a small neurosurgical subset, even though SDs are linked to poor neurological outcome and may be a modifiable therapeutic target.
• What they did: The model was trained and validated using concurrent multi-day scalp EEG and invasive subdural ECoG from 32 patients across three institutions, then tested with out-of-group hold-outs and calibration against ECoG-annotated SDs.
• The result: In an independent I-CARE cohort of 607 post–cardiac arrest comatose patients, higher WAVEFRONT SD burden on day 3 was associated with poor neurological outcome (CPC 3–4, n=29) versus good outcome (CPC 1–2, n=225; p=0.007).

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