Delayed cyclic activity development on early amplitude-integrated EEG in the preterm infant with brain lesions
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Updated: May 16, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
Giancarlo Natalucci1, Valentin Rousson, Hans Ulrich Bucher
1Department of Neonatology, University Hospital, University Children's Hospital Zurich, Zurich, Switzerland. giancarlo.natalucci@usz.ch
Insights
Amplitude-integrated electroencephalogram (aEEG) shows maturational delays in preterm infants with severe brain lesions, but amplitudes catch up. These aEEG pattern changes may indicate neurological lesions in neonates.
Area of Science:
- Neonatal neurology
- Neurophysiology
- Developmental neuroscience
Background:
- Amplitude-integrated electroencephalogram (aEEG) maturation is influenced by gestational age and postmenstrual age.
- The impact of cerebral lesions on early aEEG development in preterm infants is not fully understood.
Purpose of the Study:
- To compare early aEEG developmental changes in preterm newborns with varying degrees of cerebral lesions.
- To assess the relationship between cranial ultrasound (cUS) findings and aEEG trajectories.
Main Methods:
- Prospective cohort study of preterm infants (GA <32.0 weeks) with continuous aEEG monitoring within 84 hours of birth.
- aEEG characteristics were evaluated qualitatively and quantitatively.
- Infants were grouped based on cUS findings: normal, mild, or severe cerebral lesions.
- Linear mixed models analyzed aEEG maturational trajectories.
Main Results:
- 104 preterm infants were analyzed (mean GA 29.5 weeks).
- Newborns with severe brain lesions exhibited slower development of cyclic aEEG activity (p < 0.001).
- These infants showed a faster increase in maximum and minimum aEEG amplitudes (p = 0.002 and p = 0.04) compared to those without lesions.
Conclusions:
- Severe cerebral lesions in preterm infants are associated with early maturational delays in aEEG cyclic activity.
- Despite initial delays, aEEG amplitudes in infants with severe lesions catch up to those without lesions.
- Altered aEEG maturational patterns may serve as an early marker for severe neurological lesions in preterm neonates.
Background:
Maturation of amplitude-integrated electroencephalogram (aEEG) activity is influenced by both gestational age (GA) and postmenstrual age. It is not fully known how this process is influenced by cerebral lesions.
Objective:
To compare early aEEG developmental changes between preterm newborns with different degrees of cerebral lesions on cranial ultrasound (cUS).
Methods:
Prospective cohort study on preterm newborns with GA <32.0 weeks, undergoing continuous aEEG recording during the first 84 h after birth. aEEG characteristics were qualitatively and quantitatively evaluated using pre-established criteria. Based on cUS findings three groups were formed: normal (n = 78), mild (n = 20), and severe cerebral lesions (n = 6). Linear mixed models for repeated measures were used to analyze aEEG maturational trajectories.
Results:
104 newborns with a mean GA (range) 29.5 (24.4-31.7) weeks, and birth weight 1,220 (580-2,020) g were recruited. Newborns with severe brain lesions started with similar aEEG scores and tendentially lower aEEG amplitudes than newborns without brain lesions, and showed a slower development of the cyclic activity (p < 0.001), but a more rapid increase of the maximum and minimum aEEG amplitudes (p = 0.002 and p = 0.04).
Conclusions:
Preterm infants with severe cerebral lesions manifest a maturational delay in the aEEG cyclic activity already early after birth, but show a catch-up of aEEG amplitudes to that of newborns without cerebral lesions. Changes in the maturational aEEG pattern may be a marker of severe neurological lesions in the preterm infant.
