Related Experiment Video
Updated: Mar 15, 2026
How to Obtain Reliable Visual Event-related Potentials in Newborns
Published on: October 24, 2019
Sleep-wake cycle on amplitude-integrated EEG and neuroimage outcomes in newborns
Seonkyeong Rhie1, Kyu Young Chae1, Heui Seung Jo2
1Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, South Korea.
Insights
Delayed sleep-wake cycles detected by amplitude-integrated EEG (aEEG) in newborns with perinatal asphyxia correlate with severe brain injury. Early aEEG monitoring can help predict neurological outcomes in at-risk infants.
Area of Science:
- Neonatal neurology
- Neurophysiology
- Pediatric neuroimaging
Background:
- Perinatal hypoxic-ischemic insult affects newborns, necessitating accurate outcome prediction.
- Amplitude-integrated electroencephalography (aEEG) and neuroimaging are crucial for assessing brain injury in neonates.
- Understanding the correlation between aEEG findings and neuroimaging can refine prognostic capabilities.
Purpose of the Study:
- To evaluate sleep-wake cycle monitoring using aEEG and neuroimaging in newborns with suspected perinatal hypoxic insult.
- To investigate the correlation between aEEG and neuroimaging findings.
- To determine the predictive relevance of these findings for neurological outcome.
Main Methods:
- aEEG recordings were performed on newborns suspected of perinatal asphyxia.
- Brain imaging included serial ultrasonography and MRI.
- Infants were categorized into favorable (Group I) and severe (Group II) findings based on neuroimaging and predicted outcome.
Main Results:
- Out of 107 infants, 85 were in Group I and 22 in Group II.
- Estimated sleep-wake cycle times were significantly earlier in Group I (113.34 h) compared to Group II (504.39 h).
- Delayed cyclicity on aEEG strongly correlated with unfavorable neuroimaging findings.
Conclusions:
- Delayed sleep-wake cycle detection on aEEG is strongly associated with severe brain injury in newborns with perinatal asphyxia.
- The absence of sleep-wake cycles in the early postnatal period warrants follow-up aEEG studies.
- aEEG monitoring aids in predicting neurological outcomes in neonates following hypoxic insult.
Background:
The aim of this study was to evaluate the results of sleep-wake cycle monitoring using amplitude-integrated EEG (aEEG) and neuroimaging in newborn infants with a possible perinatal hypoxic insult, investigate the correlation between the findings, and determine the relevance of the findings to reasonably predict neurological outcome.
Methods:
aEEG was recorded among newborn infants suspected of perinatal asphyxia between November, 2014 and June, 2015 in one neonatal intensive care unit facility. Brain imaging with serial ultrasonography and MRI when available were performed, and the infants were divided into two groups according to findings and potential neurological outcome: Group I (favorable findings) and Group II (severe findings such as high grade intraventricular hemorrhage, cerebral infarction or white matter injury). Established sleep-wake cycle times after birth was compared between the two groups.
Results:
Among 107 newborn infants, 85 subjects were classified as Group I and the remaining 22 subjects as Group II. The total number of aEEG sessions was 207 and recording time was 2,796 h with a mean of 14.43 ± 13.40 h per study. Estimated times of cyclicity were earlier in Group I (113.34 h, 95 % CI 82.31-144.37) as compared to Group II (504.39 h, 95 % CI 319.91-688.88; p < 0.001).
Conclusions:
Delayed cyclicity on aEEG has a strong correlation with unfavorable brain neuroimages in newborns with possible perinatal asphyxia. If sleep-wake cycles do not appear during initial period after birth, follow-up aEEG studies are recommended.
Trial Registration:
Retrospectively registered Registration number: BD 2015-148 Name of registry: amplitude integrated EEG in neonate Date of registration: September 9, 2015.
Related Concept Videos
01:24Sleep-Wake Cycles
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
01:22Stages of Sleep
Before sleep begins, in wakefulness, the brain exhibits primarily beta waves, which are high in frequency and low in amplitude, indicating alertness...
01:23Brain Waves