Wavelet-based neurovascular coupling can predict brain abnormalities in neonatal encephalopathy

Das, Yudhajit; Leon, Rachel L.; Liu, Hanli; Kota, Srinivas; Liu, Yu-Lun; Wang, Xinlong; Zhang, Rong; Chalak, Lina F.

doi:10.1016/j.nicl.2021.102856

Cited by 15 publications

(15 citation statements)

References 48 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This difference was significant during the periods 0–24 h, 24–48 h and 0–72 h for PWC sig and for 24–48 h for PWC sig,inphase, while the trend was consistent among all time windows. These results are in agreement with Das et al 26 who reported a decreased amount of wavelet-based NVC in the 24 h of life in neonates with brain injury. The NIRS features were not significantly predictive of MRI outcome, although high rSO2 values during day 1 of cooling seem to be indicative of severe MRI outcome.…”

Section: Discussionsupporting

confidence: 93%

“…This is in keeping with findings by Chalak et al 25 who looked at wavelet coherence between amplitude-integrated EEG (aEEG) and rSO2 and found that the amount of in-phase coherence between 0.25 and 1 mHz was related to long-term developmental outcome. Similarly, Das et al 26 found that coherence between aEEG and rSO2 in very low frequencies is predictive for short-term brain injury as visible on MRI. Our outcomes were similar however with two important differences.…”

Section: Discussionmentioning

confidence: 86%

“…In the context of HIE, Govindan et al 24 utilized spectral coherence to capture coupling between EEG and NIRS signals and showed increased coherence in HIE neonates with favourable outcome. To improve the analysis of the non-stationary nature of EEG and rSO2 signals, Chalak et al 25 and Das et al 26 have recently proposed a wavelet coherence method to quantify NVC and showed that decreased coherence during TH is related to adverse short- and long-term outcome.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Partial wavelet coherence as a robust method for assessment of neurovascular coupling in neonates with hypoxic ischemic encephalopathy

Hermans

Carkeek

Dereymaeker

et al. 2023

Sci Rep

View full text Add to dashboard Cite

In neonates with hypoxic ischemic encephalopathy, the computation of wavelet coherence between electroencephalogram (EEG) power and regional cerebral oxygen saturation (rSO2) is a promising method for the assessment of neurovascular coupling (NVC), which in turn is a promising marker for brain injury. However, instabilities in arterial oxygen saturation (SpO2) limit the robustness of previously proposed methods. Therefore, we propose the use of partial wavelet coherence, which can eliminate the influence of SpO2. Furthermore, we study the added value of the novel NVC biomarkers for identification of brain injury compared to traditional EEG and NIRS biomarkers. 18 neonates with HIE were monitored for 72 h and classified into three groups based on short-term MRI outcome. Partial wavelet coherence was used to quantify the coupling between C3–C4 EEG bandpower (2–16 Hz) and rSO2, eliminating confounding effects of SpO2. NVC was defined as the amount of significant coherence in a frequency range of 0.25–1 mHz. Partial wavelet coherence successfully removed confounding influences of SpO2 when studying the coupling between EEG and rSO2. Decreased NVC was related to worse MRI outcome. Furthermore, the combination of NVC and EEG spectral edge frequency (SEF) improved the identification of neonates with mild vs moderate and severe MRI outcome compared to using EEG SEF alone. Partial wavelet coherence is an effective method for removing confounding effects of SpO2, improving the robustness of automated assessment of NVC in long-term EEG-NIRS recordings. The obtained NVC biomarkers are more sensitive to MRI outcome than traditional rSO2 biomarkers and provide complementary information to EEG biomarkers.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Partial wavelet coherence as a robust method for assessment of neurovascular coupling in neonates with hypoxic ischemic encephalopathy

Hermans

Carkeek

Dereymaeker

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…In addition to the overall changes in cerebral oxygenation during the secondary phase, there is evidence from assessment of dynamic perfusion with neural activity that cerebrovascular regulation may be impaired ( 53 ). A small prospective study of wavelet-based neurovascular coupling in term infants with HIE showed that coherence of aEEG and cerebral oxygen saturation during the first 24 h after birth was higher in infants with normal MRI than those with abnormal MRI findings ( 54 ). With a cut-off of a 10% reduction, neurovascular coupling had an area under the curve of 0.808, with a positive predictive value of 94% and negative predictive value of 52% for predicting brain abnormality on MRI, which was better than the total Sarnat score.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Oxygenation and Metabolism After Hypoxia-Ischemia

et al. 2022

View full text Add to dashboard Cite

Perinatal hypoxia-ischemia (HI) is still a significant contributor to mortality and adverse neurodevelopmental outcomes in term and preterm infants. HI brain injury evolves over hours to days, and involves complex interactions between the endogenous protective and pathological processes. Understanding the timing of evolution of injury is vital to guide treatment. Post-HI recovery is associated with a typical neurophysiological profile, with stereotypic changes in cerebral perfusion and oxygenation. After the initial recovery, there is a delayed, prolonged reduction in cerebral perfusion related to metabolic suppression, followed by secondary deterioration with hyperperfusion and increased cerebral oxygenation, associated with altered neurovascular coupling and impaired cerebral autoregulation. These changes in cerebral perfusion are associated with the stages of evolution of injury and injury severity. Further, iatrogenic factors can also affect cerebral oxygenation during the early period of deranged metabolism, and improving clinical management may improve neuroprotection. We will review recent evidence that changes in cerebral oxygenation and metabolism after HI may be useful biomarkers of prognosis.

show abstract

“…(Kirschstein and Kohling, 2009) Recently, the combination of EEG and near-infrared spectroscopy (NIRS) has demonstrated the ability to detect NVD and predict MRI-confirmed brain injury in neonates with HIBI. (Das et al, 2021) By using near-infrared light, NIRS detects cerebral oxygen saturation, a surrogate for cerebral blood flow (CBF). Diffuse correlation spectroscopy (DCS) is a similar optical technology, however it directly measures CBF at the microvascular level.…”

Section: Introductionmentioning

confidence: 99%

Correlations Between EEG Spectral Power and Cerebral Perfusion in Adults Undergoing Extracorporeal Membrane Oxygenation

Khan

Dar

Johnson

et al. 2022

Preprint

View full text Add to dashboard Cite

ObjectivePatients with acute lung or heart failure can experience hypoxic ischemic brain injury resulting in neurovascular unit (NVU) dysfunction. The NVU couples brain activity and perfusion. Extracorporeal membrane oxygenation (ECMO) is used for refractory lung and/or heart failure and often necessitates sedation, obfuscating neurological assessments. We hypothesized that combining cerebral electrographic activity and perfusion monitoring can detect brain injury in adults undergoing ECMO.MethodsFast Fourier transformation was used to identify fast (α+β) and slow (δ) power bands from cEEG. Diffuse correlation spectroscopy (DCS) measured blood flow index (BFI), a surrogate of perfusion, daily in adults undergoing ECMO. Correlations between α+β/δ ratio (ABDR) and BFI were compared between patients who were grouped into brain-injured and uninjured groups by neurologic exam and neuroimaging findings.ResultsTen patients (21-78 years old, five females, five brain-injured) underwent cEEG and DCS monitoring. Sixty-eight monitoring sessions (average 127 minutes/session) were analyzed. ABDR-BFI correlation was significantly higher in uninjured patients than brain-injured ones. Sedation did not significantly impact CBF-power band correlation.ConclusionsBrain-injured patients exhibited significantly less correlation between brain activity and perfusion, possibly as a result of NVU dysfunction.SignificanceABDR-BFI correlation can be measured continuously and noninvasively at the bedside and may represent a marker of NVU dysfunction.HighlightsQuantitative EEG and diffuse correlative spectroscopy can be used to measure markers of brain injury noninvasively, continuously, and at the bedside.Decreased ABDR-BFI correlation may be a marker of neurovascular decoupling in patients with hypoxic ischemic brain injury.ABDR-BFI correlation may be independent of analgosedation, which is used heavily in patients undergoing ECMO.

show abstract

Wavelet-based neurovascular coupling can predict brain abnormalities in neonatal encephalopathy

Cited by 15 publications

References 48 publications

Partial wavelet coherence as a robust method for assessment of neurovascular coupling in neonates with hypoxic ischemic encephalopathy

Partial wavelet coherence as a robust method for assessment of neurovascular coupling in neonates with hypoxic ischemic encephalopathy

Cerebral Oxygenation and Metabolism After Hypoxia-Ischemia

Correlations Between EEG Spectral Power and Cerebral Perfusion in Adults Undergoing Extracorporeal Membrane Oxygenation

Contact Info

Product

Resources

About