TY - JOUR
T1 - Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage
AU - Koskela, Tuomas
AU - Meek, Judith
AU - Huertas-Ceballos, Angela
AU - Kendall, Giles S
AU - Whitehead, Kimberley
N1 - Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.
Funding Information:
This work was supported by Brain Research UK, which had no role in the study design; collection, analysis and interpretation of data; writing of the report; or the decision to submit the article for publication.
Publisher Copyright:
© 2023 The Authors
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
KW - Infant
KW - Infant, Newborn
KW - Humans
KW - Infant, Premature
KW - Retrospective Studies
KW - Infant, Premature, Diseases
KW - Cerebral Hemorrhage
KW - Gestational Age
UR - http://www.scopus.com/inward/record.url?scp=85166987602&partnerID=8YFLogxK
U2 - 10.1016/j.earlhumdev.2023.105840
DO - 10.1016/j.earlhumdev.2023.105840
M3 - Article
C2 - 37556995
SN - 0378-3782
VL - 184
SP - 105840
JO - Early Human Development
JF - Early Human Development
M1 - 105840
ER -