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EEG phase-amplitude coupling to stratify encephalopathy severity in the developing brain.

Xinlong Wang1, Hanli Liu1, Srinivas Kota2

  • 1Department of Bioengineering, University of Texas at Arlington, Arlington, TX, United States.

Computer Methods and Programs in Biomedicine
|December 27, 2021
PubMed
Summary

Phase Amplitude Coupling (PAC) is a new biomarker that helps differentiate the severity of neonatal hypoxic ischemic encephalopathy (HIE) in newborns. This early classification is crucial for timely hypothermia treatment decisions.

Keywords:
EEGHypoxic ischemia encephalopathy biomarkersModified Sarnat ScoreNeonatal hypoxic ischemia encephalopathyNeural oscillation synchronyPhase amplitude coupling

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Area of Science:

  • Neonatal neurology
  • Neurophysiology
  • Biomarker discovery

Background:

  • Neonatal hypoxic-ischemic encephalopathy (HIE) requires timely classification for hypothermia therapy.
  • Current classification methods are limited within the narrow therapeutic window.
  • Neurophysiological biomarkers are essential for accurate HIE severity assessment.

Purpose of the Study:

  • To evaluate the efficacy of a novel Phase Amplitude Coupling index (PACm) as a biomarker for HIE severity.
  • To determine if PACm can differentiate between mild and severe HIE in newborns.
  • To assess the potential of PACm for guiding hypothermia treatment decisions.

Main Methods:

  • Calculated mean Phase Amplitude Coupling index (PACm) from 6-hour EEG recordings in newborns.
  • Analyzed PACm values between high (12-30 Hz) and low (1-2 Hz) frequency bands.
  • Utilized receiver operating characteristic (ROC) curves to assess PACm performance in differentiating HIE grades.

Main Results:

  • 38 newborns with varying HIE grades were included in the study.
  • A PACm threshold of 0.001 at specific EEG electrodes (Fz, O1, O2, P3, P4) demonstrated an AUC >0.9.
  • This threshold effectively differentiated HIE severity and predicted the need for hypothermia treatment.

Conclusions:

  • Phase Amplitude Coupling (PAC) shows promise as a biomarker for classifying HIE severity.
  • PACm can distinguish mild HIE from more severe cases requiring therapeutic intervention.
  • This biomarker aids in the early identification of neonates needing hypothermia therapy.