Role of EEG background activity, seizure burden and MRI in predicting neurodevelopmental outcome in full-term infants with hypoxic-ischaemic encephalopathy in the era of therapeutic hypothermia

Weeke, Lauren C.; Boylan, Geraldine B.; Pressler, Ronit; Hallberg, Boubou; Blennow, Mats; Toet, Mona C.; Groenendaal, Floris; Vries, Linda S. de

doi:10.1016/j.ejpn.2016.06.003

Cited by 60 publications

(56 citation statements)

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“…Amplitude-integrated EEG (aEEG) in particular, a filtered time-compressed continuous one- or two-channel read-out, has been demonstrated a reliable predictor in meta-analyses up to 5 years after birth (al Naqeeb et al, 1999; Sinclair et al, 1999; Toet et al, 1999; Biagioni et al, 2001; Shah D.K. et al, 2006; Nash et al, 2011; Murray et al, 2016; Weeke et al, 2016), however, some report that aEEG remains less reliable than MRI, especially following hypothermia treatment (Doyle et al, 2010; Weeke et al, 2016). The Thompson score, an EEG measure of predictive neurodevelopment, is likely to remain useful to clinicians (Thompson et al, 1997; Horn et al, 2016).…”

Section: Introduction: Global Clinical Impact Of Neonatal Hypoxia Iscmentioning

confidence: 99%

Neonatal Hypoxia Ischaemia: Mechanisms, Models, and Therapeutic Challenges

Millar

Shi

Hoerder‐Suabedissen

et al. 2017

Front. Cell. Neurosci.

246

253

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Neonatal hypoxia-ischaemia (HI) is the most common cause of death and disability in human neonates, and is often associated with persistent motor, sensory, and cognitive impairment. Improved intensive care technology has increased survival without preventing neurological disorder, increasing morbidity throughout the adult population. Early preventative or neuroprotective interventions have the potential to rescue brain development in neonates, yet only one therapeutic intervention is currently licensed for use in developed countries. Recent investigations of the transient cortical layer known as subplate, especially regarding subplate’s secretory role, opens up a novel set of potential molecular modulators of neonatal HI injury. This review examines the biological mechanisms of human neonatal HI, discusses evidence for the relevance of subplate-secreted molecules to this condition, and evaluates available animal models. Neuroserpin, a neuronally released neuroprotective factor, is discussed as a case study for developing new potential pharmacological interventions for use post-ischaemic injury.

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Section: Introduction: Global Clinical Impact Of Neonatal Hypoxia Iscmentioning

confidence: 99%

Neonatal Hypoxia Ischaemia: Mechanisms, Models, and Therapeutic Challenges

Millar

Shi

Hoerder‐Suabedissen

et al. 2017

Front. Cell. Neurosci.

246

253

View full text Add to dashboard Cite

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“…Electroencephalography (EEG) has become a routine component of neurological monitoring in the neonatal intensive care unit (NICU) ( 1 , 2 ). It has well-documented benefits in monitoring newborn infants with perinatal asphyxia ( 3 – 6 ) and seizures ( 7 – 13 ) and in predicting long-term outcome ( 14 – 21 ). Five to ten percent of newborn infants require some measure of stabilization in the delivery room (DR) ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Lost in Transition: A Systematic Review of Neonatal Electroencephalography in the Delivery Room—Are We Forgetting an Important Biomarker for Newborn Brain Health?

2017

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BackgroundElectroencephalography (EEG) monitoring is routine in neonatal intensive care units (NICUs) for detection of seizures, neurological monitoring of infants following perinatal asphyxia, and increasingly, following preterm delivery. EEG monitoring is not routinely commenced in the delivery room (DR).ObjectivesTo determine the feasibility of recording neonatal EEG in the DR, and to assess its usefulness as a marker of neurological well-being during immediate newborn transition.MethodsWe performed a systematic stepwise search of PubMed using the following terms: infant, newborns, neonate, DR, afterbirth, transition, and EEG. Only human studies describing EEG monitoring in the first 15 min following delivery were included. Infants of all gestational ages were included.ResultsTwo original studies were identified that described EEG monitoring of newborn infants within the DR. Both prospective observational studies used amplitude-integrated EEG (aEEG) monitoring and found it feasible in infants >34 weeks’ gestation; however, technical challenges made it difficult to obtain continuous reliable data. Different EEG patterns were identified in uncompromised newborns and those requiring resuscitation.ConclusionEEG monitoring is possible in the DR and may provide an objective baseline measure of neurological function. Further feasibility studies are required to overcome technical challenges in the DR, but these challenges are not insurmountable with modern technology.

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“…Professor Boylan has studied the effects of seizure burden on neurodevelopmental outcome. A high seizure burden was only associated with abnormal outcome in combination with moderate-to-severe injury on MRI [5]. In addition, a severely abnormal EEG background activity at 36-48 h after birth was associated with severe injury on MRI and an abnormal neurodevelopmental outcome.…”

mentioning

confidence: 99%