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State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Positive temporal sharp waves in preterm infants with and without brain ultrasound lesions
José Ramón Castro Conde1, Eduardo Doménech Martínez, Candelaria González Campo
1Department of Pediatrics, Faculty of Medicine, University of the La Laguna, Ofra S/N, La Laguna, S/C Tenerife 38320, Spain. jcastro@ull.es
Insights
Positive temporal sharp waves (PTS) in preterm infants are linked to major ultrasound lesions (MUL). These EEG findings correlate with poor neurologic outcomes, highlighting their sensitivity to brain injury.
Area of Science:
- Neonatal neurology
- Neurophysiology
- Developmental neuroscience
Background:
- The clinical significance of neonatal positive temporal sharp waves (PTS) remains debated.
- Understanding PTS in relation to brain injury and developmental outcomes is crucial for preterm infants.
Purpose of the Study:
- To investigate the incidence of PTS in preterm infants based on gestational age (GA) and the presence of major ultrasound lesions (MUL).
- To explore the association between PTS, other electroencephalographic (EEG) abnormalities, and poor neurologic prognoses.
Main Methods:
- A prospective study involving 97 preterm infants (<27-36 weeks GA) and 12 healthy full-term infants.
- Serial neurosonography, EEG recordings at multiple postnatal time points, and neurodevelopmental assessments at 40-42 weeks conceptional age (CA).
Main Results:
- PTS incidence peaked at 31-32 weeks GA in infants without MUL.
- In infants with MUL, PTS increased significantly from week 2 post-birth, persisting until term, especially in those <33 weeks GA.
- PTS incidence varied with sleep states and correlated with other EEG abnormalities and poor neurologic outcomes.
Conclusions:
- PTS show a significant increase in preterm infants with MUL, particularly in the early postnatal period.
- PTS are highly sensitive indicators of major ultrasound lesions in neonates.
- Abnormal EEG findings, including PTS, are associated with adverse neurologic prognoses in preterm infants.
Objective:
Clinical significance of neonatal positive temporal sharp waves (PTS) is controversial. The aim of this work is to study (1) PTS incidence in preterm infants with or without major ultrasound lesion (MUL) per gestational age (GA), and (2) the relationship between PTS in both sleep states and other electroencephalographic (EEG) findings with poor prognoses.
Methods:
97 preterm infants of <27-36 weeks GA, and 12 full-term healthy infants were presented. Prospective study included (1) neurodevelopmental assessment at 40-42 weeks conceptional age (CA), (2) serial neurosonography, and (3) EEG recording at postnatal week 1, 2, 4 and at 40-42 weeks CA.
Results:
In 50 neonates without MUL, peak PTS was at 31-32 weeks GA. In 47 neonates with MUL, PTS increased significantly from week 2 after birth, descending at the 4th. Neonates of <33 weeks GA with MUL showed significantly increased PTS at term. A significant relationship was found between PTS and other EEG abnormalities with poor neurologic prognoses. PTS incidence varied with sleep states, being predominant in indeterminate sleep in neonates with MUL.
Conclusions:
PTS increased significantly in infants with MUL, mainly at week 2 of postnatal life, persisting high until term CA, and correlated with other abnormal EEG findings.
Significance:
PTS are highly sensitive to MUL.
