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Updated: Jun 2, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
Reference values for amplitude-integrated EEGs in infants from preterm to 3.5 months of age
Dandan Zhang1, Yunfeng Liu, Xinlin Hou
1State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, 19 Xinjiekou Wai St, Beijing 100875, People's Republic of China. zhangdd05@gmail.com
Insights
This study establishes reference values for amplitude-integrated electroencephalogram (aEEG) amplitudes in infants, providing crucial quantitative guidelines for assessing brain maturation and identifying potential abnormalities.
Area of Science:
- Neonatal neurology
- Neurophysiology
- Pediatric neurology
Background:
- Amplitude-integrated electroencephalogram (aEEG) is essential for monitoring infant brain development.
- aEEG amplitudes are believed to reflect brain maturation and correlate with postmenstrual age (PMA).
Purpose of the Study:
- To establish reliable reference values for aEEG amplitudes.
- To provide quantitative guidelines for assessing brain maturation in neonates and young infants.
Main Methods:
- Analyzed aEEG data from 274 healthy infants aged 30-55 weeks PMA.
- Calculated upper and lower aEEG margins and bandwidths from 5-minute segments across 10 PMA groups.
Main Results:
- aEEG upper and lower margins increased with age, particularly after the neonatal period.
- Bandwidth decreased monotonically from 30 to 55 weeks PMA.
- The lower aEEG margin showed a strong positive correlation with PMA, especially during quiet sleep (r=0.89).
Conclusions:
- Established normative aEEG amplitude values for a wide PMA range.
- These reference values aid in the quantitative assessment of aEEG changes related to maturation.
- Normative aEEG margin data, particularly the lower margin in quiet sleep, can help identify abnormal findings.
Objectives:
Amplitude-integrated electroencephalogram (aEEG) is a valuable tool for the continuous evaluation of functional brain maturation in infants. The amplitudes of the upper and lower margins of aEEGs are postulated to change with maturation and correlate with postmenstrual age (PMA). In this study we aimed to establish reliable reference values of aEEG amplitudes, which provide quantitative guidelines for assessing brain maturation as indicated by aEEG results in neonates and young infants.
Methods:
aEEGs from healthy infants (n = 274) with PMAs that ranged from 30 to 55 weeks were divided into 10 groups according to their PMAs. Two 5-minute segments were selected from each aEEG and were used to automatically calculate the upper and lower margins and bandwidths of the aEEG tracings.
Results:
Interobserver agreement was achieved with an overall correlation of 0.99. The upper and lower margins of the aEEGs in both active and quiet sleep clearly rose in infants after the neonatal period. The bandwidth defined as the graphic distance decreased almost monotonically throughout the PMA range from 30 to 55 weeks. The lower margin of the aEEG was positively correlated with PMA, with a larger rank correlation coefficient during quiet sleep (r = 0.89) than during active sleep (r = 0.49).
Conclusions:
Reference values of aEEG amplitudes were obtained for infants with a wide range of PMAs and constituted the basis for the quantitative assessment of aEEG changes with maturation in neonates and young infants. The normative amplitudes of aEEG margins, especially of the lower margin in quiet sleep, are recommended as a source of reference data for the identification of potentially abnormal aEEG results.
