Amplitude-Integrated EEG and Brain Sparing in Preterm Small-for-Gestational-Age Infants

Benavente‐Fernández, Isabel; Lubián‐López, Simón Pedro; Zafra-Rodríguez, Pamela; Alonso‐Ojembarrena, Almudena; Segado-Arenas, Antonio

doi:10.1097/wnp.0000000000000399

Cited by 9 publications

(15 citation statements)

References 31 publications

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“…Some aEEG studies conducted in neonates with IUGR have been associated with brain function immaturity. 7,8,29 Our results provide new data, until now unreported, that contribute to a better knowledge on brain function maturation in these children. The analysis of the well-recognized EEG patterns of maturity in the clinical setting such as discontinuity, delta brushes, IBI duration, asymmetry, asynchrony or transients may have clinical relevance on the evaluation of SGA neonates.…”

Section: Visual Analysissupporting

confidence: 52%

“…[7][8][9][10][11]30,31 However, contributions in SGA babies are more limited. In premature infants with IUGR, it has been described: (1) greater relative power in δ, and lower in θ, α and β frequency bands in relation to those non-IUGR, and (2) the relative power in the δ decreases with the increase of GA. 12,13,29 In term infants, SGA neonates have been reported to have a maturational delay, defined as power spectrum increased in δ. 14 In the present work, SGA infants, compared to AGA controls, showed higher values in the power spectrum of frequencies faster (α and β) and lower in the δ.…”

Section: Spectral Analysismentioning

confidence: 99%

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Assessment of neonatal EEG background and neurodevelopment in full-term small for their gestational age infants

et al. 2019

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BACKGROUND: Delayed brain function development in small-gestational-age (SGA) infants has been reported. We aimed to quantify rates of immature neonatal EEG patterns and their association with neurodevelopment in SGA full-term neonates. METHODS: Using a cohort design, 50 SGA (birthweight <10th percentile) and 44 appropriate-gestational-age (AGA) term neonates underwent continuous video-EEG recordings lasting >3 h. Seventy-three of them were assessed at 2-years-old using Bayley-III-Scales. For EEG analysis, several segments of discontinuous/alternating EEG tracings were selected. Main outcomes measured: (1) Visual analysis (patterns of EEG maturity); (2) Power spectrum in δ, θ, α and β frequency bands; and (3) scores in motor, cognitive and language development. RESULTS: (1) SGA infants, compared to AGA, showed: (a) higher percentages of discontinuous EEG, both asynchrony and interhemispheric asymmetry, and bursts with delta-brushes, longer interburst-interval duration and more transients/hour; (b) lower relative power spectrum in δ and higher in α; and (c) lower scores on motor, language and cognitive neurodevelopment. (2) Asymmetry >5%, interburst-interval >5 s, discontinuity >11%, and bursts with delta-brushes >11% were associated with lower scores on Bayley-III. CONCLUSIONS: In this prospective study, SGA full-term neonates showed high rates of immature EEG patterns. Low-birthweight and immaturity EEG were both correlated with low development scores.

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Section: Visual Analysissupporting

confidence: 52%

Section: Spectral Analysismentioning

confidence: 99%

Assessment of neonatal EEG background and neurodevelopment in full-term small for their gestational age infants

et al. 2019

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“…They also spend up to 90% of their time sleeping (Ardura et al, 1995) whereas the full‐term neonate sleeps approximately 70% of the time (Mirmiran et al, 2003). Preterm infants are also reported to be at risk for impaired cognitive development with lower Apgar scores (Benavente‐Fernández et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Immature sleep pattern in newborn rats when dams encountered sleep restriction during pregnancy

Aswathy

Kumar

Gulia

2018

Intl J of Devlp Neuroscience

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There is a growing realization that proper sleep during pregnancy is essential for the health of the mother and the offspring. However, there are no reports on the effects of maternal sleep restriction on the sleep-wake profiles of newborns. So, this study was conducted to evaluate the effects of sleep restriction during the third term of pregnancy on the sleep-wake profiles of neonates born to them. The female pregnant Wistar rats were sleep restricted for 5 h/day on gestational days 15-20 by gentle handling. Sleep-wake profiles of the pups born to them and to the control rats were recorded on postnatal days 1-21. Pups of sleep restricted dams had higher active sleep (AS) and lower quiet sleep (QS) as well as wakefulness. Higher ratio of AS to QS, longer duration of sleep cycles, lesser bout frequency and reduced EEG delta power were also observed in these pups, all of which indicated brain immaturity. All these signs of delayed maturation, usually found in premature babies, were observed in the pups of sleep restricted mothers, who had longer gestation period. This report not only shows the importance of sleep during pregnancy, but it also suggests that neonatal sleep monitoring can be used as a tool for early assessment of retarded brain development.

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“…In the weeks following preterm birth, IUGR infants reportedly have altered EEG and amplitude integrated EEG, which has been correlated with poor neuromotor development (223, 224). In contrast, another study found that the subset of stable preterm IUGR with good clinical indices had more mature EEG patterns compared to the AGA peers (225), and similarly, preterm IUGR infants had accelerated EEG power spectrum maturation compared to preterm AGA controls at 1 month post-term equivalent age (226). However, no differences were observed at 6 months' post-term age between preterm IUGR and AGA infants, or in comparison to a term AGA group, suggesting such changes may resolve with time (226).…”

Section: Overcoming the Hurdles To Progressmentioning

confidence: 93%

Knowledge Gaps and Emerging Research Areas in Intrauterine Growth Restriction-Associated Brain Injury

et al. 2019

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Intrauterine growth restriction (IUGR) is a complex global healthcare issue. Concerted research and clinical efforts have improved our knowledge of the neurodevelopmental sequelae of IUGR which has raised the profile of this complex problem. Nevertheless, there is still a lack of therapies to prevent the substantial rates of fetal demise or the constellation of permanent neurological deficits that arise from IUGR. The purpose of this article is to highlight the clinical and translational gaps in our knowledge that hamper our collective efforts to improve the neurological sequelae of IUGR. Also, we draw attention to cutting-edge tools and techniques that can provide novel insights into this disorder, and technologies that offer the potential for better drug design and delivery. We cover topics including: how we can improve our use of crib-side monitoring options, what we still need to know about inflammation in IUGR, the necessity for more human post-mortem studies, lessons from improved integrated histology-imaging analyses regarding the cell-specific nature of magnetic resonance imaging (MRI) signals, options to improve risk stratification with genomic analysis, and treatments mediated by nanoparticle delivery which are designed to modify specific cell functions.

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Amplitude-Integrated EEG and Brain Sparing in Preterm Small-for-Gestational-Age Infants

Abstract: The results of our study suggest that SGA infants with a good prognosis have a more mature aEEG pattern than preterm adequate-for-gestational-age patients with the same outcome. These findings support the brain sparing theory in SGA infants.

Cited by 9 publications

References 31 publications

Assessment of neonatal EEG background and neurodevelopment in full-term small for their gestational age infants

Assessment of neonatal EEG background and neurodevelopment in full-term small for their gestational age infants

Immature sleep pattern in newborn rats when dams encountered sleep restriction during pregnancy

Knowledge Gaps and Emerging Research Areas in Intrauterine Growth Restriction-Associated Brain Injury

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