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Preterm EEG: A Multimodal Neurophysiological Protocol
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Seizure burden in preterm infants and smaller brain volume at term-equivalent age

Zachary A Vesoulis1, Dimitrios Alexopoulos2, Cynthia Rogers3,4

  • 1Division of Newborn Medicine, Department of Pediatrics, Washington University, St. Louis, MO, USA. vesoulis_z@wustl.edu.

Pediatric Research
|April 27, 2021
PubMed

Insights

Seizures are common in preterm infants and linked to reduced brain growth, particularly in white matter. Early seizure burden negatively impacts brain development, even when accounting for other factors.

Area of Science:

  • Neonatal neurology
  • Neurodevelopmental imaging

Background:

  • Seizures are frequently underrecognized in preterm infants.
  • The impact of early seizures on subsequent brain growth is not well understood.

Purpose of the Study:

  • To investigate the association between early seizures and brain growth in preterm infants.

Main Methods:

  • Prospective amplitude-integrated electroencephalography (aEEG) monitoring for 72 hours in infants <30 weeks gestation.
  • Term-equivalent age (TEA) magnetic resonance imaging (MRI) to assess cortical surface area (CSA) and gyrification index (GI).
  • Automated seizure detection with manual review, correlating seizure burden with brain tissue volumes.

Main Results:

  • 55% of infants experienced seizures, with greater seizure burden linked to smaller CSA and brain volumes.
  • White matter (WM) showed the most prominent reduction in volume (R² = -0.603, p < 0.01).
  • No significant association was found with the gyrification index (GI).

Conclusions:

  • Early seizures in preterm infants are common and associated with reduced brain volumes at TEA.
  • The negative impact on brain growth, especially WM, is independent of clinical confounders.
  • Further research is needed to optimize EEG monitoring and seizure treatment for improved outcomes.
Abstract

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