Why monitor the neonatal brain—that is the important question

Vanhatalo, Sampsa; Stevenson, Nathan J.; Pressler, Ronit; Abend, Nicholas S.; Auvin, Stéphane; Brigo, Francesco; Cilio, Maria Roberta; Hahn, Cecil D.; Hartmann, Hans; Hellström‐Westas, Lena; Inder, Terrie E.; Moshé, Solomon L.; Nunes, Magda Lahorgue; Shellhaas, Renée A.; Vinayan, Kollencheri Puthenveettil; Vries, Linda S. de; Wilmshurst, Jo M.; Yozawitz, Elissa; Boylan, Geraldine B.

doi:10.1038/s41390-022-02040-9

Cited by 9 publications

(6 citation statements)

References 12 publications

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“…EEG is a highly complex and detailed signal that requires experienced clinicians, pediatrics, or neonatal EEG specialists to interpret [32,33]. Therefore, the current clinical utility of this technology at the neonatal intensive care units (NICUs) is limited to units with access to experts.…”

Section: Insights On the Utility Of Computer-aided Diagnostic Algorithmsmentioning

confidence: 99%

Early Signatures of Brain Injury in the Preterm Neonatal EEG

Abbasi,

Battin,

Butler

et al. 2023

Signals

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Reliable prognostic biomarkers are needed to support the early diagnosis of brain injury in extremely preterm infants, and to develop effective neuroprotective protocols that are tailored to the progressing phases of injury. Experimental and clinical research shows that severity of neuronal damage is correlated with changes in the electroencephalogram (EEG) after hypoxic-ischemia (HI). We have previously reported that micro-scale sharp-wave EEG waveforms have prognostic utility within the early hours of post-HI recordings in preterm fetal sheep, before injury develops. This article aims to investigate whether these subtle EEG patterns are translational in the early hours of life in clinical recordings from extremely preterm newborns. This work evaluates the existence and morphological similarity of the sharp-waves automatically identified throughout the entire duration of EEG data from a cohort of fetal sheep 6 h after HI (n = 7, at 103 ± 1 day gestation) and in recordings commencing before 6 h of life in extremely preterm neonates (n = 7, 27 ± 2.0 weeks gestation). We report that micro-scale EEG waveforms with similar morphology and characteristics (r = 0.94) to those seen in fetal sheep after HI are also present after birth in recordings started before 6 h of life in extremely preterm neonates. This work further indicates that the post-HI sharp-waves show rapid morphological evolution, influenced by age and/or severity of neuronal loss, and thus that automated algorithms should be validated against such signal variations. Finally, this article discusses the need for more focused research on the early assessment of EEG changes in preterm infants to help determine the timing of brain injury to identify biomarkers that could assist in targeting novel therapies for particular phases of injury.

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Section: Insights On the Utility Of Computer-aided Diagnostic Algorithmsmentioning

confidence: 99%

Early Signatures of Brain Injury in the Preterm Neonatal EEG

Abbasi,

Battin,

Butler

et al. 2023

Signals

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“…[3][4][5] Evidence is also emerging that earlier treatment is associated with better seizure control and reduced overall seizure burden. [6][7][8] However, earlier treatment is possible only if continuous EEG monitoring is available to identify the exact onset of seizures. 6,[9][10][11] Unfortunately, multicenter studies have clearly shown that there can be long gaps between the onset of seizures and the administration of first treatment, and the reasons for this are multifactorial.…”

Section: Introductionmentioning

confidence: 99%

“…Evidence is also emerging that earlier treatment is associated with better seizure control and reduced overall seizure burden 6–8 . However, earlier treatment is possible only if continuous EEG monitoring is available to identify the exact onset of seizures 6,9–11 .…”

Section: Introductionmentioning

confidence: 99%

Translational neonatal seizure research—A reality check

Pressler

Boylan

2022

Epilepsia

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“…Electroencephalography (EEG) recording is required, as in human newborns, to both confirm the nature of the paroxysmal events as well as to identify subclinical electrographic seizures. 13 The duration of EEG recording in rodent pups poses a challenge as there are many barriers for continuous or prolonged EEG recording, including frequent nursing by dams and rapid growth of the skull that compromises the placement of the electrodes. But it is crucial to allow appropriate conclusions to be drawn with regard to the antiseizure properties of drugs.…”

mentioning

confidence: 99%

“…This might also limit the exploration of polytherapy in immature rodents due to the inability to provide such vital support/intensive care. Electroencephalography (EEG) recording is required, as in human newborns, to both confirm the nature of the paroxysmal events as well as to identify subclinical electrographic seizures 13 . The duration of EEG recording in rodent pups poses a challenge as there are many barriers for continuous or prolonged EEG recording, including frequent nursing by dams and rapid growth of the skull that compromises the placement of the electrodes.…”

mentioning

confidence: 99%