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Updated: Jul 19, 2025
A Preclinical Controlled Cortical Impact Model for Traumatic Hemorrhage Contusion and Neuroinflammation
Published on: June 10, 2020
Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage
Tuomas Koskela1, Judith Meek2, Angela Huertas-Ceballos3
1Research IT Services, University College London, London WC1E 7HB, UK.
Insights
Cortical bursting patterns in preterm infants with germinal matrix-intraventricular haemorrhage (GM-IVH) can indicate injury severity. Higher burst rates predict better outcomes, suggesting functional recovery potential.
Area of Science:
- Neonatal neurology
- Neurodevelopmental disorders
- Pediatric neurophysiology
Background:
- Cortical burst rate in healthy preterm infants predicts brain growth.
- Germinal matrix-intraventricular haemorrhage (GM-IVH) is a common complication in preterm infants.
- The prognostic value of cortical bursting in GM-IVH is not well understood.
Purpose of the Study:
- To investigate how GM-IVH affects cortical bursting patterns.
- To determine if cortical bursting predicts developmental outcomes in infants with GM-IVH.
- To explore the relationship between injury severity and cortical activity.
Main Methods:
- Retrospective cohort study of 33 preterm infants with GM-IVH (grade II or higher).
- Analysis of 47 electroencephalograms (EEGs) acquired between 24-40 weeks corrected gestational age.
- Comparison of burst rates between affected and unaffected hemispheres in asymmetric injuries.
Main Results:
- Cortical burst rate was lower in the more affected hemisphere in cases of asymmetric GM-IVH.
- Burst propagation was altered, with fewer immediate follow-up bursts from the affected hemisphere.
- Lower burst rates were observed in GM-IVH cases with parenchymal involvement.
- Higher burst rates modestly predicted survival without severe language or motor impairment.
Conclusions:
- Cortical bursting reflects functional brain injury following GM-IVH.
- Altered burst initiation and propagation indicate grey and white matter damage.
- Increased cortical burst rate is associated with a more favorable neurodevelopmental outcome.
Background:
In healthy preterm infants, cortical burst rate and temporal dynamics predict important measures such as brain growth. We hypothesised that in preterm infants with germinal matrix-intraventricular haemorrhage (GM-IVH), cortical bursting could provide prognostic information.
Aims:
We determined how cortical bursting was influenced by the injury, and whether this was related to developmental outcome.
Study Design:
Single-centre retrospective cohort study at University College London Hospitals, UK.
Subjects:
33 infants with GM-IVH ≥ grade II (median gestational age: 25 weeks).
Outcome Measures:
We identified 47 EEGs acquired between 24 and 40 weeks corrected gestational age as part of routine clinical care. In a subset of 33 EEGs from 25 infants with asymmetric injury, we used the least-affected hemisphere as an internal comparison. We tested whether cortical burst rate predicted survival without severe impairment (median 2 years follow-up).
Results:
In asymmetric injury, cortical burst rate was lower over the worst- than least-affected hemisphere, and bursts over the worst-affected hemisphere were less likely to immediately follow bursts over the least-affected hemisphere than vice versa. Overall, burst rate was lower in cases of GM-IVH with parenchymal involvement, relative to milder structural injury grades. Higher burst rate modestly predicted survival without severe language (AUC 0.673) or motor impairment (AUC 0.667), which was partly mediated by structural injury grade.
Conclusions:
Cortical bursting can index the functional injury after GM-IVH: perturbed burst initiation (rate) and propagation (inter-hemispheric dynamics) likely reflect associated grey matter and white matter damage. Higher cortical burst rate is reassuring for a positive outcome.
