Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy

Tuomas Koskela; Giles S Kendall; Sara Memon; Magdalena Sokolska; Thalitha Mabuza; Angela Huertas-Ceballos; Subhabrata Mitra; Nicola J Robertson; Judith Meek; Kimberley Whitehead

doi:10.1016/j.clinph.2021.05.031

Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy

Tuomas Koskela, Giles S Kendall, Sara Memon, Magdalena Sokolska, Thalitha Mabuza, Angela Huertas-Ceballos, Subhabrata Mitra, Nicola J Robertson, Judith Meek, Kimberley Whitehead

Digital Health & Applied Tech Assessment

Univ London, Birkbeck University London, University College London, University of London Royal Veterinary College, University of London, St Georges University London, Imperial College London, Kings College London, Royal Holloway University London, Queen Mary University London, Div Populat Hlth Sci & Educ
Institute for Women's Health
UCL Hospitals NHS Foundation Trust
Usher Institute, University of Edinburgh, Edinburgh, UK

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

OBJECTIVE: Early prediction of neurological deficits following neonatal hypoxic-ischemic encephalopathy (HIE) may help to target support. Neonatal animal models suggest that recovery following hypoxia-ischemia depends upon cortical bursting. To test whether this holds in human neonates, we correlated the magnitude of cortical bursting during recovery (≥postnatal day 3) with neurodevelopmental outcomes.

METHODS: We identified 41 surviving infants who received therapeutic hypothermia for HIE (classification at hospital discharge: 19 mild, 18 moderate, 4 severe) and had 9-channel electroencephalography (EEG) recordings as part of their routine care. We correlated burst power with Bayley-III cognitive, motor and language scores at median 24 months. To examine whether EEG offered additional prognostic information, we controlled for structural MRI findings.

RESULTS: Higher power of central and occipital cortical bursts predicted worse cognitive and language outcomes, and higher power of central cortical bursts predicted worse motor outcome, all independently of structural MRI findings.

CONCLUSIONS: Clinical EEG after postnatal day 3 may provide additional prognostic information by indexing persistent active mechanisms that either support recovery or exacerbate brain damage, especially in infants with less severe encephalopathy.

SIGNIFICANCE: These findings could allow for the effect of clinical interventions in the neonatal period to be studied instantaneously in the future.

Original language	English
Pages (from-to)	2091-2100
Number of pages	10
Journal	Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
Volume	132
Issue number	9
DOIs	https://doi.org/10.1016/j.clinph.2021.05.031
Publication status	Published - Sept 2021

Keywords

Child Development/physiology
Electroencephalography/trends
Female
Follow-Up Studies
Humans
Hypothermia, Induced/trends
Hypoxia-Ischemia, Brain/diagnosis
Infant, Newborn
Male
Prognosis
Retrospective Studies
Survivors

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10.1016/j.clinph.2021.05.031

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Koskela, T., Kendall, G. S., Memon, S., Sokolska, M., Mabuza, T., Huertas-Ceballos, A., Mitra, S., Robertson, N. J., Meek, J., & Whitehead, K. (2021). Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 132(9), 2091-2100. https://doi.org/10.1016/j.clinph.2021.05.031

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title = "Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy",

abstract = "OBJECTIVE: Early prediction of neurological deficits following neonatal hypoxic-ischemic encephalopathy (HIE) may help to target support. Neonatal animal models suggest that recovery following hypoxia-ischemia depends upon cortical bursting. To test whether this holds in human neonates, we correlated the magnitude of cortical bursting during recovery (≥postnatal day 3) with neurodevelopmental outcomes.METHODS: We identified 41 surviving infants who received therapeutic hypothermia for HIE (classification at hospital discharge: 19 mild, 18 moderate, 4 severe) and had 9-channel electroencephalography (EEG) recordings as part of their routine care. We correlated burst power with Bayley-III cognitive, motor and language scores at median 24 months. To examine whether EEG offered additional prognostic information, we controlled for structural MRI findings.RESULTS: Higher power of central and occipital cortical bursts predicted worse cognitive and language outcomes, and higher power of central cortical bursts predicted worse motor outcome, all independently of structural MRI findings.CONCLUSIONS: Clinical EEG after postnatal day 3 may provide additional prognostic information by indexing persistent active mechanisms that either support recovery or exacerbate brain damage, especially in infants with less severe encephalopathy.SIGNIFICANCE: These findings could allow for the effect of clinical interventions in the neonatal period to be studied instantaneously in the future.",

keywords = "Child Development/physiology, Electroencephalography/trends, Female, Follow-Up Studies, Humans, Hypothermia, Induced/trends, Hypoxia-Ischemia, Brain/diagnosis, Infant, Newborn, Male, Prognosis, Retrospective Studies, Survivors",

author = "Tuomas Koskela and Kendall, {Giles S} and Sara Memon and Magdalena Sokolska and Thalitha Mabuza and Angela Huertas-Ceballos and Subhabrata Mitra and Robertson, {Nicola J} and Judith Meek and Kimberley Whitehead",

year = "2021",

month = sep,

doi = "10.1016/j.clinph.2021.05.031",

language = "English",

volume = "132",

pages = "2091--2100",

journal = "Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology",

issn = "1872-8952",

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number = "9",

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Koskela, T, Kendall, GS, Memon, S, Sokolska, M, Mabuza, T, Huertas-Ceballos, A, Mitra, S, Robertson, NJ, Meek, J & Whitehead, K 2021, 'Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy', Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, vol. 132, no. 9, pp. 2091-2100. https://doi.org/10.1016/j.clinph.2021.05.031

Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy. / Koskela, Tuomas; Kendall, Giles S; Memon, Sara et al.
In: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, Vol. 132, No. 9, 09.2021, p. 2091-2100.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy

AU - Koskela, Tuomas

AU - Kendall, Giles S

AU - Memon, Sara

AU - Sokolska, Magdalena

AU - Mabuza, Thalitha

AU - Huertas-Ceballos, Angela

AU - Mitra, Subhabrata

AU - Robertson, Nicola J

AU - Meek, Judith

AU - Whitehead, Kimberley

PY - 2021/9

Y1 - 2021/9

N2 - OBJECTIVE: Early prediction of neurological deficits following neonatal hypoxic-ischemic encephalopathy (HIE) may help to target support. Neonatal animal models suggest that recovery following hypoxia-ischemia depends upon cortical bursting. To test whether this holds in human neonates, we correlated the magnitude of cortical bursting during recovery (≥postnatal day 3) with neurodevelopmental outcomes.METHODS: We identified 41 surviving infants who received therapeutic hypothermia for HIE (classification at hospital discharge: 19 mild, 18 moderate, 4 severe) and had 9-channel electroencephalography (EEG) recordings as part of their routine care. We correlated burst power with Bayley-III cognitive, motor and language scores at median 24 months. To examine whether EEG offered additional prognostic information, we controlled for structural MRI findings.RESULTS: Higher power of central and occipital cortical bursts predicted worse cognitive and language outcomes, and higher power of central cortical bursts predicted worse motor outcome, all independently of structural MRI findings.CONCLUSIONS: Clinical EEG after postnatal day 3 may provide additional prognostic information by indexing persistent active mechanisms that either support recovery or exacerbate brain damage, especially in infants with less severe encephalopathy.SIGNIFICANCE: These findings could allow for the effect of clinical interventions in the neonatal period to be studied instantaneously in the future.

AB - OBJECTIVE: Early prediction of neurological deficits following neonatal hypoxic-ischemic encephalopathy (HIE) may help to target support. Neonatal animal models suggest that recovery following hypoxia-ischemia depends upon cortical bursting. To test whether this holds in human neonates, we correlated the magnitude of cortical bursting during recovery (≥postnatal day 3) with neurodevelopmental outcomes.METHODS: We identified 41 surviving infants who received therapeutic hypothermia for HIE (classification at hospital discharge: 19 mild, 18 moderate, 4 severe) and had 9-channel electroencephalography (EEG) recordings as part of their routine care. We correlated burst power with Bayley-III cognitive, motor and language scores at median 24 months. To examine whether EEG offered additional prognostic information, we controlled for structural MRI findings.RESULTS: Higher power of central and occipital cortical bursts predicted worse cognitive and language outcomes, and higher power of central cortical bursts predicted worse motor outcome, all independently of structural MRI findings.CONCLUSIONS: Clinical EEG after postnatal day 3 may provide additional prognostic information by indexing persistent active mechanisms that either support recovery or exacerbate brain damage, especially in infants with less severe encephalopathy.SIGNIFICANCE: These findings could allow for the effect of clinical interventions in the neonatal period to be studied instantaneously in the future.

KW - Child Development/physiology

KW - Electroencephalography/trends

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hypothermia, Induced/trends

KW - Hypoxia-Ischemia, Brain/diagnosis

KW - Infant, Newborn

KW - Male

KW - Prognosis

KW - Retrospective Studies

KW - Survivors

U2 - 10.1016/j.clinph.2021.05.031

DO - 10.1016/j.clinph.2021.05.031

M3 - Article

C2 - 34284244

SN - 1872-8952

VL - 132

SP - 2091

EP - 2100

JO - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

JF - Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

IS - 9

ER -

Prognostic value of neonatal EEG following therapeutic hypothermia in survivors of hypoxic-ischemic encephalopathy

Abstract

Keywords

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