Neonatal EEG-sleep disruption mimicking hypoxic-ischemic encephalopathy after intrapartum asphyxia

Scher, Mark S.; Steppe, Doris A.; Beggarly, Marquita E.; Salerno, Dawn G.; Banks, David

doi:10.1016/s1389-9457(02)00071-0

Cited by 39 publications

(26 citation statements)

References 12 publications

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“…QS-specific differences between LPT and FT are also observed. This tendency to observe differences for specific EEG/sleep measures between LPT and FT neonatal groups during QS has been previously observed in a cohort of healthy neonates over successive days of life after neonatal depression from a difficult parturition and delivery (22). In general, environmental stress alters sleep architecture, with greater percentages of QS.…”

Section: Discussionsupporting

confidence: 69%

Physiologic Brain Dysmaturity in Late Preterm Infants

Scher

Johnson

Ludington³

et al. 2011

Pediatr Res

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Neonatal EEG sleep was used to determine if differences are expressed between healthy late preterm and full term groups. Twenty-seven 24-channel multi-hour studies were recorded at similar post–menstrual ages (PMA) and analyzed for eight asymptomatic late preterm infants (LPT) compared with nineteen healthy full term (FT) infants as a preliminary analysis, followed by a comparison of a subset of 8 FT infants, matched for gender, race, and PMA. Z scores were performed on data sets from each group pair comparing each of seven EEG/Sleep measures for entire recordings, active (AS) and quiet sleep (QS) segments and artifact-free intervals. Six of seven measures showed differences between the 8 LPT and 8 matched FT cohort pair comparisons of >0.3; REMs, arousals during QS, spectral correlations between homologous centro-temporal regions during QS, spectral beta/alpha power ratios during AS and QS, a spectral measure of respiratory regularity during QS, and sleep cycle length. Quantitative neurophysiologic analyses define differences in brain maturation between LPT and FT infants at similar PMA. Altered EEG/Sleep behaviors in the LPT are biomarkers of developmental neuroplasticity involving interconnected neuronal networks adapting to conditions of prematurity for this largest segment of the preterm neonatal population.

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Section: Discussionsupporting

confidence: 69%

Physiologic Brain Dysmaturity in Late Preterm Infants

Scher

Johnson

Ludington³

et al. 2011

Pediatr Res

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“…When placed in an extrauterine environment, an inhibitory set of responses by the prenate to conserve energy results in apnea, cessation of movements and a shift to hypometabolic EEG states with a redistribution of combined ventricular output away from peripheral organs to key organs. This inhibitory response can be transiently observed over 48 h after delivery or following asphyxia [36,37] in the term infant.…”

Section: Sleep Ontogenesis -Continuities and Discontinuities Of Statementioning

confidence: 95%

Neonatal EEG/Sleep State Analyses: A Complex Phenotype of Developmental Neural Plasticity

Scher

Loparo

2009

Dev Neurosci

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Computer analyses of EEG/sleep states can be used as physiologic biomarkers of developmental neural plasticity. Frequency- and time-dependent signal processing strategies of cerebral and noncerebral measures can help test current theories of neuronal network maturation in terms of segregation and integration of short-distance versus long-distance neuronal connections throughout the neuroaxis. Specific phenotypic expressions of adaptive or maladaptive neuronal connectivity are proposed based on comparisons of whole-brain EEG/sleep resting states between preterm and full-term cohorts when developmental outcome measures are applied. Combined use of neurophysiological datasets with neuroimaging and genetic methodologies define endophenotypes that will more accurately diagnose children at risk for developmental disorders, as well as design appropriate neuroprotective interventions for the individual’s age and disease progress.

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“…In cEEG, SWC is observed in those <30 weeks, but appears to be more disorganized. 24 In aEEG, cyclical variations were noted at a mean GA of 28 weeks in similarly immature infants. 49 Discrimination of sleep states may begin as early as 25 to 26 weeks.…”

Section: Introductionmentioning

confidence: 97%

“…A shorter time of onset, increased duration of active sleep and quality of SWC can all provide prognostic value in these cases. 23,24 Further studies are necessary to examine the relationship between aEEG and SWC in these scenarios, especially in infants undergoing therapeutic hypothermia.…”

Section: Introductionmentioning

confidence: 99%

Using amplitude-integrated EEG in neonatal intensive care

Tao

Mathur

2010

J Perinatol

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The implementation of amplitude-integrated electroencephalography (aEEG) has enhanced the neurological monitoring of critically ill infants. Limited channel leads are applied to the patient and data are displayed in a semilogarithmic, time-compressed scale. Several classifications are currently in use to describe patient tracings, incorporating voltage criteria, pattern recognition, cyclicity, and the presence or absence of seizures. In term neonates, aEEG has been used to determine the prognosis and treatment for those affected by hypoxic-ischemic encephalopathy, seizures, meningitis and even congenital heart disease. Its application as inclusion criteria for therapeutic hypothermia remains controversial. In preterm infants, normative values and patterns corresponding to gestational age are being established. As these standards emerge, the predictive value of aEEG increases, especially in the setting of preterm brain injury and intraventricular hemorrhage. The sensitivity and specificity of aEEG are enhanced by the display of a simultaneous raw EEG, which aids interpretation. Caution must be taken when using and interpreting this tool in conjunction with certain medications and in the setting of less experienced staff. Continuing efforts at developing software that can aid seizure detection and background classification will enhance the bedside utility of this tool.

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Neonatal EEG-sleep disruption mimicking hypoxic-ischemic encephalopathy after intrapartum asphyxia

Cited by 39 publications

References 12 publications

Physiologic Brain Dysmaturity in Late Preterm Infants

Physiologic Brain Dysmaturity in Late Preterm Infants

Neonatal EEG/Sleep State Analyses: A Complex Phenotype of Developmental Neural Plasticity

Using amplitude-integrated EEG in neonatal intensive care

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