Background: We aim to assess the role of quantitative electroencephalography (QEEG) derived indices to predict post-stroke disability. Methods: We included observational studies (sample-size≥10) of patients with stroke who underwent EEG and a follow-up outcome assessment was available either in form of a modified Rankin scale (mRS) or National Institute of stroke scale (NIHSS) or Fugl-Meyer scale (FMA). QEEG indices analyzed were delta-alpha ratio (DAR), delta-theta-alpha-beta ratio (DTABR), brain symmetry (BSI) and pairwise derived brain symmetry (pdBSI). Results: Twelve studies (11 had only ischemic stroke, and one had both ischemic and hemorrhagic stroke), including 513 participants were included for meta-analysis. Higher DAR was associated with worse mRS (n=300, Pearson’s r 0.26, 95% CI 0.21-0.31). Higher DTABR was associated with worse mRS (n=337, r 0.32, 95% CI 0.26-0.39). Higher DAR was associated with higher NIHSS (n=161, r 0.42, 95% CI0.24-0.6). Higher DTABR was associated with higher NIHSS (n=172, r 0.49, 95% CI 0.31-0.67). pdBSI was inversely associated with FMA (n=20, r-0.50 95% CI -0.86-(-0.14)) and BSI was not associated with FMA (n=21, r -0.3 95% CI -0.81-0.22). Conclusions: QEEG-derived indices have the potential to assess post-stroke disability. Adding QEEG to the clinical and imaging biomarkers may help in better prediction of post-stroke recovery.

PROSPERO 2022 CRD42022292281