Physiological significance of sharp wave transients on EEG recordings of healthy pre-term and full-term neonates
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Updated: Oct 20, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
M S Scher1, J M Bova, S G Dokianakis
1Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, PA 15213-3180.
Insights
Sharp wave transients (SWTs) in neonatal EEG change with brain maturation. Understanding these EEG patterns in healthy infants aids in diagnosing infant encephalopathy.
Area of Science:
- Neonatal electroencephalography (EEG)
- Neurodevelopmental monitoring
Background:
- Sharp wave transients (SWTs) are EEG findings in neonates.
- Characterizing SWTs in healthy infants is crucial for comparative analysis.
Purpose of the Study:
- To describe the characteristics of SWTs in healthy neonates.
- To investigate the relationship between SWTs and post-conceptional age, sleep state, and morphology.
Main Methods:
- Analysis of EEG sleep cycles from 52 healthy neonates (29-43 weeks post-conceptional age).
- Tabulation of 364 SWTs based on amplitude, morphology, location, and sleep state.
- Statistical analysis including correlation and ANOVA to identify significant relationships.
Main Results:
- SWT frequency and amplitude varied across full-term, preterm, and post-term age groups.
- Specific EEG locations (FP1, FP2, T4, C3) were common sites for SWTs.
- Biphasic and triphasic wave morphologies differed significantly between preterm and full-term infants (P=0.001).
- SWT amplitude correlated significantly with post-conceptional age (r=0.45, P=0.0001).
- SWT frequency and amplitude were significantly influenced by EEG site, sleep state, and morphology (P=0.0001).
Conclusions:
- Brain maturation significantly impacts the location and morphology of SWTs in healthy neonates.
- Established normative data for SWTs in healthy infants can enhance the interpretation of clinical EEG recordings.
Abstract:
One EEG sleep cycle was selected from each of ninety-four 3 h studies on 52 healthy neonates from 29 to 43 weeks post-conceptional ages (CA) (28 pre-term (PT)/24 full-term infants (FT); 51 are normal up to at least 18 months of age). Each record was reviewed to identify sharp wave transients (SWTs). No spike discharges were noted. 364 SWTs were tabulated in terms of amplitude, morphology, left:right predominance, anatomical site and EEG sleep state. Mean number of SWTs per hour for full-term, pre-term, and pre-term at post-conceptional term age (PTT) infants were 11.7 (+/- 12), 10.0 (+/- 7), and 13 (+/- 10). Mean amplitudes (microV) were 98.8 (+/- 23.2), 84.9 (+/- 38.3), and 99.4 (+/- 28.8) for FT, PT, and PTT infants respectively. FP1, FP2, T4 and C3 accounted for 94%, 83% and 84% of SWT sites for FT, PT and PTT groups, respectively. Biphasic waves were noted more frequently, and triphasic waves almost exclusively in PT infants (chi 2 = 130.8, P = 0.001). Spearman correlations were significant for amplitude of SWTs with CA (and r = 0.45, P = 0.0001). Significant differences (ANOVA) were found, for instance, between SWT frequency with the site and sleep state (R2 = 0.63, P = 0.0001) between SWT amplitude with sleep state and morphology (R2 = 0.59, P = 0.0001). Brain maturation alters the location and morphology of SWTs in healthy neonates. Descriptions of SWTs on EEG recordings of healthy neonates will improve the assessment of encephalopathic recordings of infants studied for clinical reasons.
