Amplitude-integrated electroencephalography in preterm infants with cystic periventricular leukomalacia
Introduction
Despite advances in neonatal intensive care, periventricular leukomalacia (PVL) is still one of the most important causes of neurological impairment in preterm infants. Affected infants suffer from various neurological sequelae, including motor and cognitive impairments, visual problems, and epilepsy. We reported previously that a conventional electroencephalogram (EEG) was a powerful tool to assess brain damage, such as PVL, in preterm infants during the early neonatal period [1], [2], [3], [4], [5], [6].
Amplitude-integrated electroencephalography (aEEG) has been widely used as a continuous brain-function monitoring tool in neonatal intensive care units. aEEG examination and interpretation are much easier than those of conventional EEG. aEEG is very useful for predicting neurodevelopmental outcomes in asphyxiated term infants. Although several studies have assessed aEEG findings in preterm infants with intraventricular hemorrhage during the early neonatal period [7], [8], [9], [10], its clinical significance in preterm infants has hardly been determined. In particular, few reports have addressed aEEG findings in preterm infants with PVL during the early neonatal period. We hypothesized that aEEG would reveal differences between infants with cystic PVL and normal infants. The aim of this study was to determine the details of aEEG findings in preterm infants with cystic PVL using visual and quantitative analyses.
Section snippets
Patients
Three hundred thirty preterm infants of less than 34 weeks gestational age were admitted to the neonatal intensive care unit of Okazaki City Hospital between January 1999 and December 2006. We examined cranial ultrasonography in all patients almost every day during the first week of life and at least once weekly thereafter until discharge using a Hewlett-Packard Image Point HX with 7.5 MHz probes (Philips Medical Systems, Andover, MA, USA) and evaluated the findings according to previously
Results
The patients' characteristics are presented in Table 1. The second EEG record was not obtained in one infant with cystic PVL. No statistically significant difference was observed in any item between the two groups except for the third EEG recording on the day after birth. However, the post-conceptional age of the third EEG recording showed no significant difference between groups. No infant had received sedative medications.
Cranial ultrasonography grading during the neonatal period, follow-up
Discussion
Using visual and quantitative analyses, we revealed that the upper-margin amplitudes, and bandwidth spans of the aEEG at 6–13 days after birth were much higher in infants with cystic PVL than in the normal control infants. We thought that the increased upper-margin amplitude of the aEEG in infants with PVL would reflect the disorganized patterns of conventional EEG [3], [4], [6]. In fact, conventional EEG showed moderate to severe disorganized patterns in all infants with PVL at 6–13 days after
Conflict of interest statement
We do not have any financial relationships with pharmaceutical companies, medical equipment manufacturers, biomedical device manufacturers, or any companies with significant involvement in the field of health care. We have no conflict of interest in relation with this manuscript.
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Developmental change of amplitude-integrated electroencephalographic activity in preterm infants with intraventricular hemorrhage
2013, Early Human DevelopmentCitation Excerpt :Comparative studies of aEEG versus conventional EEG have been performed to assess the sensitivity of the two techniques for neonatal seizure detection [4,5]. In addition, aEEG appears to reflect brain function status in infants with various diseases, such as congenital heart disease [6], bronchopulmonary dysplasia [7], sepsis [8], and periventricular leukomalacia (PVL) [9]. Intraventricular hemorrhage (IVH) is one of the major morbidities in preterm infants.
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Value of amplitude-integrated electroencephalograph in early diagnosis and prognosis prediction of neonatal hypoxic-ischemic encephalopathy
2014, International Journal of Clinical and Experimental Medicine