Neonatal spectral EEG is prognostic of cognitive abilities at school age in premature infants without overt brain damage

Abstract

Prematurity is a prototype of biological risk that could affect the late neurocognitive outcome; however, the condition itself remains a non-specific marker. This longitudinal 6-year study aimed to evaluate the prognostic role of neonatal spectral EEG in premature infants without neurological complications. The study cohort was 26 children born 23–34 gestational ages; all neonates underwent multichannel EEG recordings at 35 weeks post-conception. EEG data were transformed into the frequency domain and divided into delta (0.5–4 Hz), theta (5–7 Hz), alpha (8–13 Hz), and beta (14–20 Hz) frequency bands. At 6 years, a neuropsychological and behavioral evaluation was performed. Correlations between spectral bands and neuropsychological assessments were performed with a conservative and robust Bayesian correlation model using weakly informative priors. The correlation of neuropsychological tasks to spectral frequency bands highlighted a significant association with visual and auditory attention tests. The performance on the same tests appears to be mainly impaired. Conclusions: We found that spectral EEG frequencies are independent predictors of performance in attention tasks. We hypothesized that spectral EEG might reflect early circuitries’ imbalance in the reticular ascending system and cumulative effect on ongoing development, pointing to the importance of early prognostic instruments. What is Known:• Prematurity is a non-specific marker of late neurocognitive risk.• Precise prognostic instruments are lacking, mostly in patients with low-grade conditions.What is New:• Longitudinal long-term studies are scarce but crucial for the inferential attributive process.• Spectral EEG frequencies are independent predictors of performance in attention tasks.

Long-Term Outcomes after Neonatal Hypoxic-Ischemic Encephalopathy in the Era of Therapeutic Hypothermia: A Longitudinal, Prospective, Multicenter Case-Control Study in Children without Overt Brain Damage

“…This means that the cognitive profile of children with HIE is not homogeneously lower than that of their peers, but that they show profiles characterized by deficits and preserved functions. This result is in line with our previous work on other preperinatal conditions [27][28][29]. As in those studies, we found high interindividual variability as demonstrated by highly variable scores in the performance of tasks or responses to the questionnaires.…”

Prediction Effect of Amplitude-Integrated EEG on the Brain Damage and Long-Term Nervous System Development of Late Preterm Infants

“…Preterm infants with lower GA may have accelerated brain maturation within 2 weeks after birth, suggesting that preterm infants are prone to brain development abnormalities and brain damage during this period. The results of a one-week aEEG monitoring experiment for deficient birth weight infants starting 12–48 hours after birth confirmed [ 15 ] that early aEEG examination within 1 week after birth can predict the poor prognosis of preterm infants. If it is combined with cranial ultrasonography, it can improve the sensitivity to the poor prognosis of preterm infants.…”

Cognitive Outcome Prediction in Infants With Neonatal Hypoxic-Ischemic Encephalopathy Based on Functional Connectivity and Complexity of the Electroencephalography Signal

“…To the best of our knowledge, our study is the first prospective study to date performed in neonates (in the first week of birth) investigating early non-linear qEEG characteristics (WPLI and complexity measures) and their prognostic value for cognitive outcome at 24 months of age. Furthermore, all studies existing in literature have used the linear qEEG such as coherence (Kühn-Popp et al, 2016), EEG continuity (West et al, 2005), and spectral power (Suppiej et al, 2017;Cainelli et al, 2021), which may not be optimal to capture the complex characteristics of the EEG spectra. Non-linear methods adopted in this study provided deep insight into the underlying brain functions and dynamics.…”

“…Non-linear methods adopted in this study provided deep insight into the underlying brain functions and dynamics. Several studies investigated the frequency activity underlying EEG by spectrally analyzing the signal using methods that rely on the predefined frequency of traditional brainwaves, as in Kühn-Popp et al (2016), Suppiej et al (2017), andCainelli et al (2021). Prior selection of frequency ranges may result in potentially informative brain waves being missed, specifically in the case of infants, due to the well-known variability between them and older individuals in the neural oscillations of interest.…”

“…The EEG data was recorded at 35 weeks post-conception, and the outcome was evaluated at 1 year of age with the Griffiths' scales. Cainelli et al (2021) carried out a longitudinal 6-year study to evaluate the feasibility of neonatal spectral EEG in predicting developmental delay in premature infants. The EEG data was recorded at 35 weeks post-conception, and the outcome was assessed at 6 years using Wechsler Pre-school and Primary Scale of Intelligence III.…”