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Updated: Jul 10, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
Background patterns and sleep-wake cycles on amplitude-integrated electroencephalography in preterms younger than 30
Monika Olischar1, Katrin Klebermass, Thomas Waldhoer
1Division of General Pediatrics and Neonatology, Department of Pediatrics and Adolescent Medicine, Center for Public Health, Medical University of Vienna, Austria. monika.olischar@meduniwien.ac.at
Insights
Amplitude-integrated electroencephalography (aEEG) shows that severe peri-/intraventricular haemorrhage (PIVH) in preterm infants (<30 weeks gestational age) is linked to discontinuous brain activity, fewer sleep-wake cycles, and increased seizure risk compared to controls.
Area of Science:
- Neonatal neurology
- Clinical neurophysiology
- Pediatric critical care
Background:
- Peri-/intraventricular haemorrhage (PIVH) is a common complication in preterm infants.
- Amplitude-integrated electroencephalography (aEEG) is a valuable tool for monitoring brain function in neonates.
- Understanding the impact of PIVH on aEEG patterns is crucial for early detection and management.
Purpose of the Study:
- To investigate the relationship between PIVH severity (grades I-IV) and aEEG activity in preterm infants (<30 weeks gestational age).
- To compare aEEG findings in infants with PIVH to those of neurologically healthy preterm infants.
Main Methods:
- Prospective study of 56 preterm infants (<30 weeks GA) with PIVH grades I-IV over 2 weeks of life.
- Analysis of aEEG tracings for background patterns, seizure activity, and sleep-wake cycles.
- Comparison with aEEG data from 75 neurologically healthy preterm infants without PIVH.
Main Results:
- Increased PIVH grades correlated with decreased continuous aEEG activity and increased discontinuous activity.
- Seizure activity was more frequent with higher PIVH grades in infants 23-26 weeks GA.
- Sleep-wake cycles were less common in infants with more severe PIVH.
Conclusions:
- Severe PIVH in preterm infants is characterized by discontinuous aEEG background patterns.
- Lack of sleep-wake cycles and increased seizure likelihood are associated with severe PIVH.
- aEEG provides insights into the neurological impact of PIVH in extremely preterm infants.
Aim:
The objective of this prospective study was to evaluate the influence of peri-/intraventricular haemorrhage (PIVH) grades I-IV on amplitude-integrated electroencephalographic (aEEG) activity in preterm infants<30 weeks gestational age (GA).
Methods:
The aEEG tracings of the first 2 weeks of life of 56 preterm infants younger than 30 weeks GA (2 groups: group A=23-26 weeks GA, group B=27-29 weeks GA) born during a 4-year period with PIVH grades I-IV were assessed for the relative duration of four background aEEG activity patterns (continuous pattern, discontinuous high-voltage pattern, discontinuous low-voltage pattern and nearly isoelectric pattern), the presence of seizure activity and the appearance of sleep-wake cycles and compared to the tracings of 75 neurologically healthy preterms without PIVH.
Results:
Analysis of aEEG background activity showed a decrease of continuous activity whereas discontinuous activity increased in both groups with larger haemorrhages (grades III and IV) and when compared to controls. Suspected seizure activity was more common with increasing degree of bleeding in group A (50% with PIVH I or II, 75% with PIVH III or IV) and when compared to controls and was the same with increasing degree of bleeding in group B (47% with PIVH I or II, 45% with PIVH III or IV). Sleep-wake cycles were less common with larger haemorrhages in both groups (group A: 41% with PIVH I or II, 25% with PIVH III or IV; group B: 52% with PIVH I or II, 9% with PIVH III or IV) and when compared to controls.
Conclusions:
The aEEG characteristics of severe PIVH consist in a combination of a more discontinuous background pattern, a lack of sleep-wake cycles and a higher likelihood of seizure activity when compared to age-matched controls.
