Wavelet-based neurovascular coupling can predict brain abnormalities in neonatal encephalopathy.

Area of Science:

• Neonatal neurology
• Biomarkers of brain injury
• Neurophysiology

Background:

• Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity.
• Current methods for predicting HIE outcomes early are limited.
• There is a need for real-time physiologic biomarkers to guide therapy.

Purpose of the Study:

• To evaluate if neurovascular coupling (NVC) calculated within 24 hours of birth can predict abnormal brain MRI in neonatal HIE.
• To assess the utility of wavelet transform coherence (WTC) analysis of NIRS and aEEG for NVC assessment.

Main Methods:

• Simultaneous recording of aEEG and cerebral tissue oxygen saturation (SctO2) for 24 hours post-birth.
• Wavelet transform coherence (WTC) analysis to quantify NVC (R²).
• Comparison of NVC metrics between neonates with normal and abnormal brain MRIs.

Main Results:

• Significant differences in SctO2-aEEG coherence (p=0.0007) were observed in the very low-frequency range between normal and abnormal MRI groups.
• WTC-based NVC analysis demonstrated an AUC of 0.808 for predicting brain injury.
• NVC prediction showed higher sensitivity and specificity compared to the Total Sarnat score.

Conclusions:

• Neurovascular coupling (NVC) is a promising neurophysiological biomarker for predicting HIE outcomes.
• Early NVC assessment using WTC analysis is superior to the Total Sarnat score in predicting abnormal brain MRI in neonatal HIE.