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Early Electroencephalography Suppression and Postnatal Morbidities Correlate with Cerebral Volume at Term-Equivalent
Sverre Wikström1, Holger Hövel, Ingrid Hansen Pupp
1School of Medical Sciences, Örebro University, Örebro, Sweden.
Insights
Early suppressed electroencephalography (EEG) activity in very preterm infants is linked to reduced brain volume and increased cerebrospinal fluid volume at term. Postnatal morbidities further impact brain development.
Area of Science:
- Neonatal neuroscience
- Developmental neurobiology
- Clinical neurophysiology
Background:
- Early brain activity is a predictor of long-term outcomes.
- Understanding early life influences on preterm brain development is crucial.
- Relating early brain activity to postnatal brain growth can enhance this understanding.
Purpose of the Study:
- To investigate the association between early electroencephalography (EEG) activity and brain volumes at term in very preterm infants.
- To determine if postnatal morbidity influences this association.
Main Methods:
- Single-channel EEG recordings were obtained from very preterm infants (n=38) within 72 hours of age.
- Interburst interval percentage (IBI%), a measure of EEG suppression, was analyzed.
- EEG data were correlated with brain volumes measured by MRI at term-equivalent age, adjusting for gestational age and morbidities.
Main Results:
- Higher IBI% (more suppressed EEG) was associated with increased cerebrospinal fluid volume (CSFV) and reduced total brain volume relative to intracranial volume.
- An increase in IBI% by 1 SD corresponded to a 0.7 SD increase in CSFV and a 0.7 SD decrease in brain volume.
- Infants with two or more postnatal morbidities exhibited approximately 10% lower brain volumes.
Conclusions:
- Suppressed early EEG activity in very preterm infants correlates with lower brain volume and higher CSFV at term.
- These findings highlight the significance of pre- and early postnatal factors, potentially including activity-dependent mechanisms, in regulating postnatal brain growth.
- The study underscores the importance of early brain activity monitoring for predicting neurodevelopmental outcomes in preterm infants.
Background:
Early brain activity is associated with long-term outcome. Establishing a relation also with postnatal brain growth may increase our understanding of early life influences on preterm brain development.
Objectives:
The aim of this study was to investigate whether early electroencephalography (EEG) activity in infants born very preterm is associated with brain volumes at term, and whether postnatal morbidity affects this association.
Methods:
Very preterm infants (n = 38) with a median gestational age (GA) of 25.6 weeks had early recordings of single-channel EEG. The percentage of suppressed EEG, i.e., interburst intervals (IBI%) between 24 and 72 h of age, was analyzed in relation to brain volumes on magnetic resonance imaging performed at term-equivalent age, taking into account neonatal morbidities.
Results:
Early electrocortical depression and a higher IBI% were associated with increased cerebrospinal fluid volume (CSFV) and lower total brain volume relative to intracranial volume, also after adjustment for GA, postnatal morbidities, morphine administration, and postnatal head growth. Overall, an increase in IBI% to 1 SD from the mean corresponded with an increase in CSFV to +0.7 SD and a decrease in brain volume to -0.7 SD. The presence of 2 or more postnatal morbidities were associated with around 10% lower brain volumes.
Conclusions:
More suppressed early EEG activity of very preterm infants is associated with lower brain volume and increased CSFV at term age, also when adjusting for postnatal morbidities. The findings indicate the importance of pre- and early postpartal determinants of postnatal brain growth, possibly also including activity-dependent mechanisms for brain growth.