Applying a data-driven approach to quantify EEG maturational deviations in preterms with normal and abnormal neurodevelopmental outcomes

Abstract

Premature babies are subjected to environmental stresses that can affect brain maturation and cause abnormal neurodevelopmental outcome later in life. Better understanding this link is crucial to developing a clinical tool for early outcome estimation. We defined maturational trajectories between the electroencephalography (eeG)-derived 'brain-age' and postmenstrual age (the age since the last menstrual cycle of the mother) from longitudinal recordings during the baby's stay in the neonatal Intensive Care Unit. Data consisted of 224 recordings (65 patients) separated for normal and abnormal outcome at 9-24 months follow-up. Trajectory deviations were compared between outcome groups using the root mean squared error (RMSE) and maximum trajectory deviation (δ max). 113 features were extracted (per sleep state) to train a data-driven model that estimates brain-age, with the most prominent features identified as potential maturational and outcome-sensitive biomarkers. RMSE and δ max showed significant differences between outcome groups (cluster-based permutation test, p < 0.05). RMSE had a median (IQR) of 0.75 (0.60-1.35) weeks for normal outcome and 1.35 (1.15-1.55) for abnormal outcome, while δ max had a median of 0.90 (0.70-1.70) and 1.90 (1.20-2.90) weeks, respectively. Abnormal outcome trajectories were associated with clinically defined dysmature and disorganised EEG patterns, cementing the link between early maturational trajectories and neurodevelopmental outcome.

Early Diagnosis of Brain Injury in Premature Infants Based on Amplitude-Integrated EEG Scoring System

“…Severe brain damage in premature infants can lead to death or moderate-to-severe neurodevelopmental disorders, including cerebral palsy, mental retardation, and vision and hearing impairment, and seriously affect the quality of life of preterm infants [4,5]. erefore, the early evaluation and prevention of brain injury and its adverse neurological prognosis in preterm infants have become the focus of medical research in preterm infants.…”

Quiet Sleep Organization of Very Preterm Infants Is Correlated With Postnatal Maturation

“…However, we find these preliminary results informative in view to develop an automated detection method. Our proposal to evaluate behavioral approach with regard to correlation with PMA is not unique, it has been recently used in two studies using EEG ( 53 , 54 ). The observed correlation were also high in those studies and quite similar than in our study.…”

“…The observed correlation were also high in those studies and quite similar than in our study. In the study of Pillay et al ( 53 ) a 10–20 electrode EEG system was used to quantify EEG maturation of QS evaluated on 30 s epoch with a Median recording duration of 4 h 23 min in 21 preterm infants using a data-driven approach based on EEG features which didn't take into account percentage of time spent in QS or ADI (69 recordings). The observed r 2 value of correlation between the estimated brain age and the PMA was of 0.85–0.88.…”

A Deep Shared Multi-Scale Inception Network Enables Accurate Neonatal Quiet Sleep Detection With Limited EEG Channels

“…Recordings were acquired at a sampling frequency of 250 Hz using the BrainRT EEG recording system (OSG BVBA Rumst, Belgium) and were annotated as states of QS and non-QS (NQScombining AS and Wakefulness) by an expert clinical neurophysiologist (AD). All recordings were anonymized by the clinicians before analysis and further details about the demographics are given in [1], [27]. This database was also previously used in [6], [9], [13], [23], [24].…”