Hypoxic ischaemic encephalopathy (HIE), an important complication of perinatal asphyxia, remains a major health burden. Neonates are classifi ed using the Sarnat score and neonates >35 weeks with moderate/ severe HIE are treated with therapeutic hypothermia (TH). TH improves survival/ decreases disability however 30-50% of mild HIE cases (not offered TH) develop cognitive impairment. Early biomarkers are vital to redefi ne HIE and better manage these infants. Cerebral monitoring is essential to establish cerebral activity, categorise encephalopathy stages, diagnose seizures, and monitor treatment. EEG and near infrared spectroscopy (NIRS) may be used concomitantly as monitoring tools (combined cerebral activity and haemodynamics) in order to study neurovascular coupling (NVC). NVC as a biomarker may increase sensitivity and specifi city for HIE outcome prediction. Limited research exists on NVC in neonates and in HIE where lower oxygen saturation may exist, physiological patterns may be altered. Easy integration of EEG and NIRS, continuous results over long periods, different clinical settings, favors studies. NVC analysis may identify neonates at risk earlier and reduce neurodevelopmental disabilities. AIM:-Study continuous EEG and NIRS data in HIE.-Measure NVC as biomarker for asphyxia severity -Identify/establish patterns of outcome prediction -Study effects of physiological variability and medication on NVC. METHODOLOGY:-Single center retrospective cohort study -UZ Leuven, Belgium: 10-year period 2010 -2020.-Establish database and inclusions.-Inclusion: 72 hours TH, EEG and NIRS, magnetic resonance imaging (MRI) < day 10 of life.-Demographic and clinical data (REDCap system) -Statistical analysis using GraphPad Prism.-MRIs scored blinded (Weeke HIE score). Score = 0 considered normal outcome, 1-2 a mild/moderate and >2 severe HIE. Comparisons between groups were performed.