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Amplitude-integrated EEG recorded at 32 weeks postconceptional age. Correlation with MRI at term

Abstract

Objective

The study aims to establish the role of late aEEG (scored by Burdjalov) in predicting brain maturation as well as abnormalities evaluated at term equivalent age (TEA) by brain MRI.

Methods

91 infants born before 30 wks gestation underwent an aEEG monitoring at 32 wks postconceptional age (PCA). aEEG, was correlated with TEA MRI, scored by Kidokoro.

Results

A significant correlation between the aEEG score and the MRI scores was found. The same results were obtained for the aEEG continuity score; cyclicity and bandwidth scores were associated with grey matter and cerebellar MRI items. Moreover, a correlation between aEEG and cEEG recorded both at 32 and 40 wks PCA, was found.

Conclusions

aEEG monitoring can be predictive of MRI findings at TEA, suggesting that it could be implemented as a useful tool to support ultrasound to help identify neonates who will benefit from early intervention services.

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References

  1. Burdjalov VF, Baumgart S, Spitzer AR. Cerebral function monitoring: a new scoring system for the evaluation of brain maturation in neonates. Pediatrics. 2003;112:855–61.

    Article  Google Scholar 

  2. Volpe JJ. The encephalopathy of prematurity–brain injury and impaired brain development inextricably intertwined. Semin Pediatr Neurol. 2009;16:167–78.

    Article  Google Scholar 

  3. Aarnoudse-Moens CS, Weisglas-Kuperus N, van Goudoever JB, Oosterlaan J. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics. 2009;124:717–28.

    Article  Google Scholar 

  4. Rushe TM, Rifkin L, Stewart AL, Townsend JP, Roth SC, Wyatt JS, et al. Neuropsychological outcome at adolescence of very preterm birth and its relation to brain structure. Dev Med child Neurol. 2001;43:226–33.

    Article  CAS  Google Scholar 

  5. Ibrahim J, Mir I, Chalak L. Brain imaging in preterm infants <32 weeks gestation: a clinical review and algorithm for the use of cranial ultrasound and qualitative brain MRI. Pediatr Res. 2018;84:799–806. Dec

    Article  CAS  Google Scholar 

  6. Fogtmann EP, Plomgaard AM, Greisen G, Gluud C. Prognostic accuracy of electroencephalograms in preterm infants: a systematic review. Pediatrics. 2017;139:e20161951.

    Article  Google Scholar 

  7. Kong A, Lai MM, Finnigan S, Ware RS, Boyd RN, Colditz PB. Background EEG features and prediction of cognitive outcomes in very preterm infants: a systematic review. Early Hum Dev. 2018;127:74–84.

    Article  Google Scholar 

  8. Stevenson NJ, Tataranno ML, Kaminska A, Pavlidis E, Clancy RR, Griesmaier E, et al. Reliability and accuracy of EEG interpretation for estimating age in preterm infants. Ann Clin Transl Neurol. 2020;7:1564–73.

    Article  Google Scholar 

  9. Le Bihannic A, Beauvais K, Busnel A, de Barace C, Furby A. Prognostic value of EEG in very premature newborns. Arch Dis Child. 2012;97:F106–F109. 2012

    Article  Google Scholar 

  10. Brouwer MJ, Kersbergen KJ, van Kooij B, Benders M, van Haastert IC, Koopman-Esseboom C, et al. Preterm brain injury on term-equivalent age MRI in relation to perinatal factors and neurodevelopmental outcome at two years. PloS One. 2017;12:e0177128.

    Article  Google Scholar 

  11. Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE. Neonatal MRI to predict neurodevelopmental outcomes in preterm infants. N Engl J Med. 2006;355:685–94.

    Article  CAS  Google Scholar 

  12. Hintz SR, Barnes PD, Bulas D, Slovis TL, Finer NN, Wrage LA, et al. Neuroimaging and neurodevelopmental outcome in extremely preterm infants. Pediatrics. 2015;135:e32–e42.

    Article  Google Scholar 

  13. Hintz SR, Vohr BR, Bann CM, Taylor HG, Das A, Gustafson KE, et al. Preterm neuroimaging and school-age cognitive outcomes. Pediatrics. 2018;142:e20174058.

    Article  Google Scholar 

  14. Smyser CD, Kidokoro H, Inder TE. Magnetic resonance imaging of the brain at term equivalent age in extremely premature neonates: to scan or not to scan? J Paediatr Child Health. 2012;48:794–800.

    Article  Google Scholar 

  15. El Ters NM, Vesoulis ZA, Liao SM, Smyser CD, Mathur AM. Term-equivalent functional brain maturational measures predict neurodevelopmental outcomes in premature infants. Early Hum Dev. 2018;119:68–72.

    Article  Google Scholar 

  16. El Ters NM, Vesoulis ZA, Liao SM, Smyser CD, Mathur AM. Impact of brain injury on functional measures of amplitude-integrated EEG at term equivalent age in premature infants. J Perinatol. 2017;37:947–52.

    Article  CAS  Google Scholar 

  17. Natalucci G, Leuchter RH, Bucher HU, Latal B, Koller B, Hüppi PS, et al. Functional brain maturation assessed during early life correlates with anatomical brain maturation at term-equivalent age in preterm infants. Pediatr Res. 2013;74:68–74.

    Article  Google Scholar 

  18. Lago P, Garetti E, Merazzi D, Pieragostini L, Ancora G, Pirelli A, et al. Guidelines for procedural pain in the newborn. Acta Paediatr. 2009;98:932–9.

    Article  CAS  Google Scholar 

  19. Pisani F, Facini C, Pelosi A, Mazzotta S, Spagnoli C, Pavlidis E. Neonatal seizures in preterm newborns: a predictive model for outcome. Eur J Paediatr Neurol. 2016;20:243–51.

    Article  Google Scholar 

  20. Holmes GL, Lombroso CT. Prognostic value of background patterns in the neonatal EEG. J Clin Neurophysiol. 1993;10:323–52.

    Article  CAS  Google Scholar 

  21. Kidokoro H, Neil JJ, Inder TE. New M. R. imaging assessment tool to define brain abnormalities in very preterm infants at term. Am J Neuroradiol. 2013;34:2208–14.

    Article  CAS  Google Scholar 

  22. George JM, Fiori S, Fripp J, Pannek K, Bursle J, Moldrich RX, et al. Validation of an MRI brain injury and growth scoring system in very preterm infants scanned at 29- to 35-week postmenstrual age. Am J Neuroradiol. 2017;38:1435–42.

    Article  CAS  Google Scholar 

  23. Plaisier A, Govaert P, Lequin MH, Dudink J. Optimal timing of cerebral MRI in preterm infants to predict long-term neurodevelopmental outcome: a systematic review. Am J Neuroradiol. 2014;35:841–7.

    Article  CAS  Google Scholar 

  24. Al Naqeeb N, Edwards AD, Cowan FM, Azzopardi D. Assessment of neonatal encephalopathy by amplitude-integrated electroencephalography. Pediatrics 1999;103:1263–71.

    Article  CAS  Google Scholar 

  25. Tao JD, Mathur AM. Using amplitude-integrated EEG in neonatal intensive care. J Perinatol. 2010;30:S73–S81.

    Article  Google Scholar 

  26. Bruns N, Dransfeld F, Hüning B, Hobrecht J, Storbeck T, Weiss C, et al. Comparison of two common aEEG classifications for the prediction of neurodevelopmental outcome in preterm infants. Eur J Pediatr. 2017;176:163–71.

    Article  CAS  Google Scholar 

  27. Song J, Xu F, Wang L, Gao L, Guo J, Xia L, et al. Early amplitude-integrated electroencephalography predicts brain injury and neurological outcome in very preterm infants. Sci Rep. 2015;5:13810.

    Article  Google Scholar 

  28. Kidokoro H, Kubota T, Hayashi N, Hayakawa M, Takemoto K, Kato Y, et al. Absent cyclicity on aEEG within the first 24 h is associated with brain damage in preterm infants. Neuropediatrics. 2010;41:241–5.

    Article  CAS  Google Scholar 

  29. Reynolds LC, Pineda RG, Mathur A, Vavasseur C, Shah DK, Liao S, et al. Cerebral maturation on amplitude-integrated electroencephalography and perinatal exposures in preterm infants. Acta Paediatr. 2014;103:e96–e100.

    Article  Google Scholar 

  30. Klebermass K, Olischar M, Waldhoer T, Fuiko R, Pollak A, Weninger M. Amplitude-integrated EEG pattern predicts further outcome in preterm infants. Pediatr Res. 2011;70:102–8.

    Article  Google Scholar 

  31. Okumura A, Hayakawa M, Oshiro M, Hayakawa F, Shimizu T, Watanabe K. Nutritional state, maturational delay on electroencephalogram, and developmental outcome in extremely low birth weight infants. Brain Dev. 2010;32:613–8.

    Article  Google Scholar 

  32. Chalak LF, Sikes NC, Mason MJ, Kaiser JR. Low-voltage aEEG as predictor of intracranial hemorrhage in preterm infants. Pediatr Neurol. 2011;44:364–9.

    Article  Google Scholar 

  33. Inder TE, Buckland L, Williams CE, Spencer C, Gunning MI, Darlow BA, et al. Lowered electroencephalographic spectral edge frequency predicts the presence of cerebral white matter injury in premature infants. Pediatrics. 2003;111:27–33.

    Article  Google Scholar 

  34. Hellstrom-Westas L, Klette H, Thorngren-Jerneck K, Rosen I. Early prediction of outcome with aEEG in preterm infants with large intraventricular hemorrhages. Neuropediatrics. 2001;32:319–24.

    Article  CAS  Google Scholar 

  35. Bowen JR, Paradisis M, Shah D. Decreased aEEG continuity and baseline variability in the first 48 h of life associated with poor short-term outcome in neonates born before 29 weeks gestation. Pediatr Res. 2010;67:538–44.

    Article  Google Scholar 

  36. Ho T, Dukhovny D, Zupancic JA, Goldmann DA, Horbar JD, Pursley DM. Choosing wisely in newborn medicine: five opportunities to increase value. Pediatrics. 2015;136:e482–e489.

    Article  Google Scholar 

  37. Périvier M, Rozé JC, Gascoin G, Hanf M, Branger B, Rouger V, et al. Neonatal EEG and neurodevelopmental outcome in preterm infants born before 32 weeks. Arch Dis Child Fetal Neonatal Ed. 2016;101:F253–F259.

    Article  Google Scholar 

  38. Meledin I, Abu Tailakh M, Gilat S, Yogev H, Golan A, Novack V, et al. Comparison of amplitude-integrated EEG and conventional EEG in a cohort of premature infants. Clin EEG Neurosci. 2017;48:146–54.

    Article  Google Scholar 

  39. Toet MC, van der Meij W, de Vries LS, Uiterwaal CS, van Huffelen KC. Comparison between simultaneously recorded amplitude integrated electroencephalogram (cerebral function monitor) and standard electroencephalogram in neonates. Pediatrics. 2002;109:772–9.

    Article  Google Scholar 

  40. Davis AS, Gantz MG, Do B, Shankaran S, Hamrick SE, Kennedy KA, et al. Serial aEEG recordings in a cohort of extremely preterm infants: feasibility and safety. J Perinatol. 2015;35:373–8.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank Elisa Maietti for encouragement and support. PP is grateful to Camilla degli Scrovegni for continuous support. We are indebted to our medical, EEG technicians and nursing colleagues, the infants and their parents who agreed to take part in this study.

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Authors and Affiliations

Authors

Contributions

AT conceptualized and designed the study, participated in data acquisition, interpreted aEEG traces and wrote the manuscript. MN participated in acquisition of data and revised the article critically for content. JS interpreted brain MRI scans and participated in acquisition of data. AA interpreted conventional EEG traces and participated in acquisition of data. PP conceptualized the study, supervised data collection, and reviewed the manuscript. GA conceptualized and designed the study, interpreted aEEG traces, analyzed and interpreted data, wrote the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Anna Tarocco.

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Tarocco, A., Natile, M., Sarajlija, J. et al. Amplitude-integrated EEG recorded at 32 weeks postconceptional age. Correlation with MRI at term. J Perinatol 42, 880–884 (2022). https://doi.org/10.1038/s41372-021-01295-0

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