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Impact of brain injury on functional measures of amplitude-integrated EEG at term equivalent age in premature infants

Journal of Perinatology volume 37, pages 947–952 (2017)Cite this article

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Abstract

Objective:

To evaluate the association between qualitative and quantitative amplitude-integrated EEG (aEEG) measures at term equivalent age (TEA) and brain injury on magnetic resonance imaging (MRI) in preterm infants.

Study Design:

A cohort of premature infants born at <30 weeks of gestation and with moderate-to-severe MRI injury on a TEA MRI scan was identified. A contemporaneous group of gestational age-matched control infants also born at <30 weeks of gestation with none/mild injury on MRI was also recruited. Quantitative aEEG measures, including maximum and minimum amplitudes, bandwidth span and spectral edge frequency (SEF90), were calculated using an offline software package. The aEEG recordings were qualitatively scored using the Burdjalov system. MRI scans, performed on the same day as aEEG, occurred at a mean postmenstrual age of 38.0 (range 37 to 42) weeks and were scored for abnormality in a blinded manner using an established MRI scoring system.

Results:

Twenty-eight (46.7%) infants had a normal MRI or mild brain abnormality, while 32 (53.3%) infants had moderate-to-severe brain abnormality. Univariate regression analysis demonstrated an association between severity of brain abnormality and quantitative measures of left and right SEF90 and bandwidth span (β=−0.38, −0.40 and 0.30, respectively) and qualitative measures of cyclicity, continuity and total Burdjalov score (β=−0.10, −0.14 and −0.12, respectively). After correcting for confounding variables, the relationship between MRI abnormality score and aEEG measures of SEF90, bandwidth span and Burdjalov score remained significant.

Conclusion:

Brain abnormalities on MRI at TEA in premature infants are associated with abnormalities on term aEEG measures, suggesting that anatomical brain injury may contribute to delay in functional brain maturation as assessed using aEEG.

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Acknowledgements

We thank Mike Wallendorf, Jim Alexopoulos and Anthony Barton for their help in data collection, organization and processing. This work was funded by (1) Intellectual and Developmental Disabilities Research Center (IDDRC) at Washington University (NIH/NICHD P30 HD062171), (2) Washington University Institute of Clinical and Translational Sciences KL2 Training Program (NIH/NCATS KL2 TR000450), (3) The Barnes-Jewish Hospital Foundation and the Washington University Institute of Clinical and Translational Sciences Clinical and Translational Funding Program (NIH/NCATS UL1 TR000448), (4) R01 HD057098 and (5) The Dana Foundation, Cerebral Palsy International Research Foundation, Child Neurology Foundation.

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Authors and Affiliations

  1. Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA

    N M El Ters, Z A Vesoulis, S M Liao & A M Mathur

  2. Division of Pediatric Neurology, Washington University School of Medicine, St Louis, MO, USA

    C D Smyser

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  1. N M El Ters
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Correspondence to N M El Ters.

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El Ters, N., Vesoulis, Z., Liao, S. et al. Impact of brain injury on functional measures of amplitude-integrated EEG at term equivalent age in premature infants. J Perinatol 37, 947–952 (2017). https://doi.org/10.1038/jp.2017.62

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