Large-scale coupling in neuronal activity is essential in all cognitive functions, but its emergence and functional correlates are poorly known in the human newborn. This study aimed to characterize functional connectivity in the healthy human newborn, and to identify the changes in connectivity related to vigilance states and to maturation during the early postnatal weeks. We recorded active and quiet sleep of 38 sleeping newborn babies using multichannel electroencephalography (EEG) at 2 neonatal time points. Functional connectivity between brain areas was quantified with 3 different metrics: phase-phase correlations, amplitude-amplitude correlations (AACs), and phase-amplitude correlations. All functional connectivity measures changed significantly between vigilance states and matured rapidly after normal birth. The observed changes were frequency-specific, most salient in AAC coupling, and their development was compatible with the known development of structural cortico-cortical connectivity. The present findings support the view that emerging functional connectivity exhibits fundamental differences between sleep states months before the onset of genuine EEG signatures of sleep states. Moreover, our findings also support the idea that early cortical events entail different mechanisms of functional coupling needed to provide endogenous guidance for early activity-dependent development of brain networks.

SUMMARYObjective: Prenatal exposure to antiepileptic drugs (AEDs) is associated with an increased risk of cognitive dysfunction at early school age. Our aim was to investigate whether signs of adverse drug effects on brain function could be detected already during the first 2 weeks of life. Methods: We studied prospectively 56 full-term newborns with prenatal exposure to AEDs and 67 unexposed newborns for the following characteristics: Background information, AED exposure data, pregnancy outcome, neuropsychological evaluation of the mothers, clinical neurologic status with Hammersmith Neonatal Neurological Examination and early cortical activity using electroencephalography (EEG). For EEG assessment, we developed and provide automated quantitation algorithms of several earlier described features: oscillatory bouts at theta and alpha frequencies, frequency spectra, interhemispheric synchrony, and interburst intervals (IBIs). Results: The AED-exposed newborns had lower limb and axial tone and were less irritable than the unexposed newborns. EEG assessment disclosed significant differences in alpha bouts, in the frequency spectra, as well as in the spatial distributions of interhemispheric synchrony and IBIs. Significance: The results indicate that fetal AED exposure may affect early neonatal neurologic status and several features of early cortical activity. The findings suggest that interference of activity-dependent network development may be a possible mechanism to explain the link from fetal AED exposure to later neurocognitive sequelae. KEY WORDS: Epilepsy, Pregnancy, Neonatal, EEG.Epilepsy affects about 0.3-0.7% of pregnant women.

Recent experimental animal studies have shown that fetal exposure to serotonin reuptake inhibitors (SRIs) affects brain development. Modern recording methods and advanced computational analyses of scalp electroencephalography (EEG) have opened a possibility to study if comparable changes are also observed in the human neonatal brain. We recruited mothers using SRI during pregnancy (n = 22) and controls (n = 62). Mood and anxiety of mothers, newborn neurology, and newborn cortical function (EEG) were assessed. The EEG parameters were compared between newborns exposed to drugs versus controls, followed by comparisons of newborn EEG features with maternal psychiatric assessments. Neurological assessment showed subtle abnormalities in the SRI-exposed newborns. The computational EEG analyses disclosed a reduced interhemispheric connectivity, lower cross-frequency integration, as well as reduced frontal activity at low-frequency oscillations. These effects were not related to maternal depression or anxiety. Our results suggest that antenatal serotonergic treatment might change newborn brain function in a manner compatible with the recent experimental studies. The present EEG findings suggest links at the level of neuronal activity between human studies and animal experiments. These links will also enable bidirectional translation in future studies on the neuronal mechanisms and long-term neurodevelopmental effects of early SRI exposure.