Spectral analysis of neonatal sleep is useful for studying brain maturation; however, most studies have analyzed conventional broad bands described for awake adults, so a distinct approach for EEG analysis may disclose new findings. Study Objectives To extract independent EEG broad bands using principal component analysis (PCA) and describe week-by-week EEG changes in quiet sleep (QS) and active sleep (AS) during the first 5 weeks of postnatal life in healthy, full-term newborns. Methods Polysomnography of spontaneous sleep was recorded in 60 newborns in 5 groups at 41, 42, 43, 44, and 45 weeks (n = 12 each) postconceptional age (POST-C). QS and AS stages were identified. Absolute power (AP) for 1 Hz bins between 1 and 30 Hz was subjected to PCA to extract independent broad bands. Results PCA rendered three independent broad bands distinct from conventional bands. They explained 82.8% of variance: 2–10 Hz, 10–16 Hz, and 17–30 Hz. ANOVAs (group × age × derivations) showed significant higher power at 2–10 Hz with greater age, higher power in QS than AS in all three bands, and significantly higher AP in the left central region, and in the right occipital and temporal areas, in both sleep stages. Conclusion A different method of analyzing sleep EEG generated new information on brain maturation. The Sigma frequencies identified suggest that sleep spindle maturation begins by at least 41 weeks of POST-C age. Interhemispheric asymmetries during sleep suggest earlier development of the central left region and the right occipital and temporal areas.

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BACKGROUND: Consensus on the defi nition and management of hypotension in preterm neonates is lacking.(1-3) Owing to this, there are wide variations in the reported incidence of hypotension in premature infants, especially in the fi rst week from birth.(1,3,4) Inotropes can often cause vasoconstriction, which may alter brain perfusion especially in the absence of established cerebral autoregulation.(5) The use of these drugs is associated with multiple short and long term morbidities.(2,6-12) Studies that targeted blood pressure alone as the criteria for use of inotropes did not show improvement in mortality and morbidity. (12,13) We evaluated the effect of quality improvement (QI) bundle on rate of inotrope use and associated morbidities. METHODS: Inborn preterm neonates born at <29weeks gestational age (GA) and admitted to level III NICU were

These results indicate that changes in amplitude and latency of some VEP components observed in NREM and REM sleep in adults are not yet present in one month old newborns probably due to immaturity of cortical and sleep mechanisms. VEPs are more reliable during AS than QS in newborns. Systematic VEP recording during AS, and polysomnographic control to identify this stage, are highly recommended as methods that can increase there liability of neonatal VEPs.

Aim: To evaluate electroencephalography (EEG) connectivity during the first year of age in healthy full-term infants and preterm infants with prenatal and perinatal risk factors for perinatal brain damage. Methods: Three groups of infants were studied: healthy full-term infants (n = 71), moderate/late-preterm infants (n = 54), and very preterm infants (n = 56). All preterm infants had perinatal and/or perinatal risk factors for brain damage. EEG was obtained during phase II of natural nonrapid eye movement (NREM) sleep. EEG analysis was performed in 24 2.56-s artifact-free segments. For the calculation of EEG sources, spectral structured sparse Bayesian learning (sSSBL) was used. Connectivity was computed by the phase-lag index. Results: In healthy full-term infants, EEG interhemispheric connectivity in the different frequency bands followed similar trends with age to those reported in each frequency band: delta connectivity decreased, theta increased at the end of the year, the alpha band showed different trends based on the region studied, and beta interhemispheric connectivity decreased with age. EEG connectivity in preterm infants showed differences from the results of the term group. Discussion: Important structural findings may explain the differences observed in EEG connectivity between the term and preterm groups. Conclusion: The study of EEG connectivity during the first year of age provides essential information on normal and abnormal brain development.