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Networks of cortical activity show graded responses to perinatal asphyxia
Timo Syvälahti1,2, Anna Tuiskula3,4, Päivi Nevalainen5,3
1Department of Clinical Neurophysiology, Children´s Hospital, and Epilepsia Helsinki, full member of ERN EpiCare, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland. timo.syvalahti@helsinki.fi.
Insights
Newborn brain activity shows a graded response to perinatal asphyxia, even in mild cases. Computational EEG analysis can help assess the severity of hypoxic-ischemic encephalopathy (HIE) and predict outcomes.
Area of Science:
- Neonatal neurology
- Computational neuroscience
- Pediatric critical care
Background:
- Perinatal asphyxia can cause hypoxic-ischemic encephalopathy (HIE), leading to neurodevelopmental issues.
- The brain effects of mild HIE following perinatal asphyxia are not well understood.
- This study investigates the dose-response relationship between asphyxia severity and cortical activity networks in newborns.
Purpose of the Study:
- To test if newborn cortical activity networks demonstrate a dose-response to perinatal asphyxia.
- To explore the correlation between asphyxia severity and early clinical recovery.
- To evaluate the utility of computational EEG metrics in assessing neonatal brain function.
Main Methods:
- Electroencephalogram (EEG) recordings were obtained from 52 infants with perinatal asphyxia/HIE and 53 controls.
- Computational metrics were used to analyze cortical network activity from EEG data.
- Severity of asphyxia/HIE was categorized to assess graded effects.
Main Results:
- Graded alterations in cortical activity networks were observed, correlating with the severity of asphyxia/HIE.
- These network changes were associated with early clinical recovery, specifically the time to full oral feeding.
- Findings suggest a continuum of effects rather than discrete categories of HIE.
Conclusions:
- Increasing severity of hypoxic-ischemic encephalopathy (HIE) impacts both local and large-scale cortical activity.
- Automated computational EEG measures can characterize the effects of perinatal adversity on the neonatal brain.
- These metrics show promise for patient stratification and early outcome assessment in clinical trials.
Background:
Perinatal asphyxia often leads to hypoxic-ischemic encephalopathy (HIE) with a high risk of neurodevelopmental consequences. While moderate and severe HIE link to high morbidity, less is known about brain effects of perinatal asphyxia with no or only mild HIE. Here, we test the hypothesis that cortical activity networks in the newborn infants show a dose-response to asphyxia.
Methods:
We performed EEG recordings for infants with perinatal asphyxia/HIE of varying severity (n = 52) and controls (n = 53) and examined well-established computational metrics of cortical network activity.
Results:
We found graded alterations in cortical activity networks according to severity of asphyxia/HIE. Furthermore, our findings correlated with early clinical recovery measured by the time to attain full oral feeding.
Conclusion:
We show that both local and large-scale correlated cortical activity are affected by increasing severity of HIE after perinatal asphyxia, suggesting that HIE and perinatal asphyxia are better represented as a continuum rather than the currently used discreet categories. These findings imply that automated computational measures of cortical function may be useful in characterizing the dose effects of adversity in the neonatal brain; such metrics hold promise for benchmarking clinical trials via patient stratification or as early outcome measures.
Impact:
Perinatal asphyxia causes every fourth neonatal death worldwide and provides a diagnostic and prognostic challenge for the clinician. We report that infants with perinatal asphyxia show specific graded responses in cortical networks according to severity of asphyxia and ensuing hypoxic-ischaemic encephalopathy. Early EEG recording and automated computational measures of brain function have potential to help in clinical evaluation of infants with perinatal asphyxia.
