Early amplitude-integrated electroencephalography predicts brain injury and neurological outcome in very preterm infants

Abstract

Early amplitude-integrated electroencephalography (aEEG) has been widely used in term infants with brain injury to predict neurodevelopmental outcomes; however, the prognostic value of early aEEG in preterm infants is unclear. We evaluated how well early aEEG could predict brain damage and long-term neurodevelopmental outcomes in very preterm infants compared with brain imaging assessments. We found that severe aEEG abnormalities (p = 0.000) and aEEG total score < 5 (p = 0.006) within 72 h after birth were positively correlated with white-matter damage, but aEEG abnormalities were not associated with intracranial hemorrhage (p = 0.186). Severe abnormalities in aEEG recordings, head ultrasound, and cranial magnetic resonance imaging (MRI) were all positively correlated with poor outcome at 18 months corrected age. The predictive power of poor outcomes of the aEEG and MRI combination was the same as the aEEG, MRI, and head ultrasound combination with a sensitivity of 52.4%, specificity of 96.2%, positive predictive value of 78.6%, and negative predictive value of 88.4%. These results indicate that severely abnormal aEEG recordings within 72 h after birth can predict white-matter damage and long-term poor outcomes in very preterm infants. Thus aEEG can be used as an early marker to monitor very preterm infants.

Recombinant human erythropoietin improves neurological outcomes in very preterm infants

“…If infants had blood transfusions, blood samples were collected at least 3 days after that. Head ultrasound was performed on all patients within 3 days after birth and then weekly until discharge (at least 4 sessions of ultrasonography were performed, which depended on the gestational age), and cerebral magnetic resonance imaging (MRI) was performed at 40 weeks of corrected age to determine the presence and extent of brain injury, hemorrhage, or thrombosis 26. Data regarding complications of prematurity, including ICH, PVL, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), sepsis, and ROP, were recorded.…”

Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy

“…Individual metrics of electroencephalography6131415 and near-infrared spectroscopy (NIRS)1617 have been used independently to assess the function of neurovascular unit, but the ability to study coupling in real time of NIRS and EEG in HIE has received little attention11171819 These methods demonstrated that a severe asphyxia insult leads to impaired function, but the extent of dysfunctional neurovascular coupling (NVC), and its impact on clinical outcome of newborns with encephalopathy cannot be currently assessed in real time due to limited methodology2021.…”

Effectiveness of Interventions on Early Neurodevelopment of Preterm Infants: A Systematic Review and Meta-Analysis

“…One systematic review on developmental care (10) recommended combining electroencephalography (EEG) to a measure of neurobehavioral development for assessing the effectiveness of interventions with preterm infants. Recent advances support the idea that brain activity and oxygenation during the neonatal period play a crucial role in the preservation and development of brain connections, and thus in infants' brain functioning and growth (43,44), and can predict their neurodevelopmental status in early childhood (45,46). Therefore, combined with other standardized instruments, EEG as a measure of infants' neurodevelopment could be used in future studies.…”