# Delta-Band EEG Microstate Dynamics as Promising Candidate Markers of Central Vertigo Severity

## TL;DR

This study finds that brainwave patterns in the delta frequency band could help measure how severe central vertigo is in patients.

## Contribution

The study introduces delta-band EEG microstate transitions as a novel biomarker for assessing central vertigo severity.

## Key findings

- Delta-band microstate transitions correlated strongly with symptom severity and balance confidence in CV patients.
- A specific delta-band transition (C to B) accurately distinguished moderate from severe CV cases with high accuracy (AUC = 0.983).
- EEG microstate dynamics in the delta band showed severity-dependent alterations in patients with central vertigo.

## Abstract

Background/Objectives: Central vertigo (CV) lacks objective biomarkers for severity assessment. This study examined whether resting-state EEG microstate dynamics across frequency bands can distinguish CV severity. Methods: Resting-state EEG was recorded from 50 patients with stroke-related CV and 31 healthy controls. Patients were classified as moderate (MD, n = 31) or severe (SV, n = 19) based on Dizziness Handicap Inventory scores. Microstate analysis was performed in the delta, theta, alpha, and beta bands to assess microstate topographies, temporal parameters, and transition probabilities. Correlations with clinical measures and receiver operating characteristic analyses were conducted. Results: CV patients showed severity-dependent alterations in EEG microstate dynamics, most pronounced in the delta band. Delta-band microstate transition probabilities correlated significantly with symptom severity and balance confidence. The delta-band transition from microstate C to microstate B accurately differentiated MD from SV patients (AUC = 0.983). Conclusions: Delta-band EEG microstate transition dynamics reflect network dysfunction in CV and may serve as promising candidate biomarkers for CV severity stratification.