Normal EEG during the neonatal period: maturational aspects from premature to full-term newborns

Bourel-Ponchel, Emilie; Guéden, Sophie; Hasaerts, Danielle; Heberlé, Claire; Malfilâtre, Geneviève; Mony, Luc; Vignolo-Diard, Patricia; Lamblin, Marie‐Dominique

doi:10.1016/j.neucli.2020.10.004

Cited by 29 publications

(30 citation statements)

References 66 publications

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“…Cortical bursts in preterm neonates can be evoked by sensory stimulation, but can also occur spontaneously in the absence of external stimuli (Whitehead et al, 2016) (Supplementary Video 2). These spontaneous activities occur with varying spatial configurations (Arichi et al, 2017) which overlap with those evoked by external stimulation (Bourel-Ponchel et al, 2021; Wallois et al, 2021; Whitehead et al, 2016). Here we show that the response to a somatosensory input is suppressed if the background cortical activity preceding the stimulus onset closely resembles that evoked by the stimulus itself.…”

Section: Discussionmentioning

confidence: 99%

“…The preterm electroencephalograph (EEG) is characterised by high voltage transient events (delta brushes and temporal theta) separated by low amplitude inter-burst intervals until about 35 weeks (Wallois et al, 2021). These spontaneous activity bursts occur with varying topographical configurations (Arichi et al, 2017) which can sometimes resemble those evoked by external stimulation (Bourel-Ponchel et al, 2021; Wallois et al, 2021; Whitehead et al, 2016). The diagnostic and prognostic importance of this characteristic pattern of activity is well established (Guérit et al, 2009; Watanabe et al, 1999; Whitehead et al, 2016), however, its aetiology, i.e.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous activation of cortical somatosensory networks depresses their excitability in preterm human neonates

Whitehead

Rupawala

Laudiano‐Dray

et al. 2022

Preprint

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Introduction: The activity of the developing cortex is characteristically discontinuous where sudden high amplitude bursts interrupt periods of quiescent background. While the functional importance of this activity is clear, its aetiology is not known. Here, we hypothesise that this alternating pattern arises because of 'refractoriness' of cortical networks following spontaneous activation. Methods: To test this hypothesis, we assessed whether spontaneous activity in sensory networks depressed their excitability by measuring the impact of ongoing activity on the response to an external sensory stimulus. We recorded cortical activity before and after mechanical tactile stimulation of hands and feet in 35 preterm infants of median 32 weeks post-menstrual age. Results: Mechanical stimulation evoked wideband energy increases with two distinct peaks within the delta and alpha-beta band. The delta activity engaged extended cortical areas, while the faster activity engaged local somatotopically specific areas. By then characterising the spectro-spatial properties of the spontaneous activity preceding stimulation, we showed that baseline energy with a distribution and spectral profile similar to that of somatosensory-evoked activity dampened the energy changes elicited by touching the body. Discussion: Sensory-evoked activity in preterm human neonates likely represents the coordinated activation of extended (tangential) and local (e.g. columnar) cortical aggregates. The occurrence of spontaneous cortical events in the same cortical regions depresses their excitability preventing their immediate re-engagement. This 'refractoriness' offers the first etiological explanation to the cyclical burst-quiescence pattern typical of preterm cortical activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spontaneous activation of cortical somatosensory networks depresses their excitability in preterm human neonates

Whitehead

Rupawala

Laudiano‐Dray

et al. 2022

Preprint

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“…28 These patterns vary greatly from adult EEG patterns and change with each subsequent week of gestational age. EEG changes in response to tactile and auditory stimuli are not present until the equivalent of 28 to 30 weeks of gestation ex utero, 29 and differences in EEG responses to noxious (eg, heel stick) and nonnoxious stimuli (touch) are present at 35 weeks of gestation ex utero. 30 However, although such studies provide some information on the development of brain activity in the newborn, these reported findings are specific to the neonate and cannot be extrapolated to the fetus.…”

Section: How Is Pain Assessed?mentioning

confidence: 98%

Society for Maternal-Fetal Medicine Consult Series #59: The use of analgesia and anesthesia for maternal-fetal procedures

Norton

Cassidy

Ralston

et al. 2021

American Journal of Obstetrics and Gynecology

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and Gynecologists (ACOG) endorses this document. The Royal College of Obstetricians and Gynaecologists (RCOG) supports this document.Pain is a complex phenomenon that involves more than a simple physical response to external stimuli. In maternal-fetal surgical procedures, fetal analgesia is used primarily to blunt fetal autonomic responses and minimize fetal movement. The purpose of this Consult is to review the literature on what is known about the potential for fetal awareness of pain and to discuss the indications for and the risk-benefit calculus involved in the use of fetal anesthesia and analgesia. The recommendations by the Society for Maternal-Fetal Medicine are as follows: (1) we suggest that fetal paralytic agents be considered in the setting of intrauterine transfusion, if needed, for the purpose of decreasing fetal movement (GRADE 2C);(2) although the fetus is unable to experience pain at the gestational age when procedures are typically performed, we suggest that opioid analgesia should be administered to the fetus during invasive fetal surgical procedures to attenuate acute autonomic responses that may be deleterious, avoid long-term consequences of nociception and physiological stress on the fetus, and decrease fetal movement to enable the safe execution of procedures (GRADE 2C); and (3) due to maternal risk and a lack of evidence supporting benefit to the fetus, we recommend against the administration of fetal analgesia at the time of pregnancy termination (GRADE 1C).

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“…En el caso de los registros realizados en infantes y los aspectos particulares de la señal y artefactos, la señal del EEG tiene características distintas en comparación a la señal obtenida en adultos. Esto se debe a que el sistema nervioso de los infantes se encuentra en un proceso de maduración, donde se están estableciendo dinámicas neurales mediante, por ejemplo, la poda neural, sinaptogénesis, mielinización de axones, entre otros (Bourel-Ponchel, Gueden, Hasaerts, Héberlé, Malfilâtre, Mony, Vignolo-Diard & Lamblin, 2021;Wallois, Routier, Heberlé, Mahmoudzadeh, Bourel-Ponchel & Moghimi, 2021). Así, por ejemplo, cuando se compara la actividad de infantes prematuros a los de término, se ha encontrado que la amplitud de la señal del EEG va disminuyendo así como el contenido oscilatorio de la frecuencia más dominante se desplaza a una frecuencia más alta (Bourel-Ponchel et al, 2021).…”

Section: ¿Qué Es La Señal Del Eeg?unclassified

“…Esto se debe a que el sistema nervioso de los infantes se encuentra en un proceso de maduración, donde se están estableciendo dinámicas neurales mediante, por ejemplo, la poda neural, sinaptogénesis, mielinización de axones, entre otros (Bourel-Ponchel, Gueden, Hasaerts, Héberlé, Malfilâtre, Mony, Vignolo-Diard & Lamblin, 2021;Wallois, Routier, Heberlé, Mahmoudzadeh, Bourel-Ponchel & Moghimi, 2021). Así, por ejemplo, cuando se compara la actividad de infantes prematuros a los de término, se ha encontrado que la amplitud de la señal del EEG va disminuyendo así como el contenido oscilatorio de la frecuencia más dominante se desplaza a una frecuencia más alta (Bourel-Ponchel et al, 2021). En lo que respecta a artefactos, las fuentes son muy similares a las que se encuentran en otros tipos de registros de electroencefalografía.…”

Section: ¿Qué Es La Señal Del Eeg?unclassified

Electroencefalografía y seguimiento de mirada: Dos técnicas para evaluar la adquisición de la lengua materna en niños pequeños

2022

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Normal EEG during the neonatal period: maturational aspects from premature to full-term newborns

Cited by 29 publications

References 66 publications

Spontaneous activation of cortical somatosensory networks depresses their excitability in preterm human neonates

Spontaneous activation of cortical somatosensory networks depresses their excitability in preterm human neonates

Society for Maternal-Fetal Medicine Consult Series #59: The use of analgesia and anesthesia for maternal-fetal procedures

Electroencefalografía y seguimiento de mirada: Dos técnicas para evaluar la adquisición de la lengua materna en niños pequeños

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