Coupling between mean blood pressure and EEG in preterm neonates is associated with reduced illness severity scores

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dc.contributor.author Semenova, Oksana
dc.contributor.author Lightbody, Gordon
dc.contributor.author O'Toole, John M.
dc.contributor.author Boylan, Geraldine B.
dc.contributor.author Dempsey, Eugene M.
dc.contributor.author Temko, Andriy
dc.date.accessioned 2018-09-20T15:53:40Z
dc.date.available 2018-09-20T15:53:40Z
dc.date.issued 2018
dc.identifier.citation Semenova, O., Lightbody, G., O’Toole, J. M., Boylan, G., Dempsey, E. and Temko, A. (2018) 'Coupling between mean blood pressure and EEG in preterm neonates is associated with reduced illness severity scores', PLOS ONE, 13(6), e0199587 (24pp). doi: 10.1371/journal.pone.0199587 en
dc.identifier.volume 13
dc.identifier.issued 6
dc.identifier.startpage 1
dc.identifier.endpage 24
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/6830
dc.identifier.doi 10.1371/journal.pone.0199587
dc.description.abstract Hypotension or low blood pressure (BP) is a common problem in preterm neonates and has been associated with adverse short and long-term neurological outcomes. Deciding when and whether to treat hypotension relies on an understanding of the relationship between BP and brain functioning. This study aims to investigate the interaction (coupling) between BP and continuous multichannel unedited EEG recordings in preterm infants less than 32 weeks of gestational age. The EEG was represented by spectral power in four frequency sub-bands: 0.3 +/- 3 Hz, 3 +/- 8 Hz, 8 +/- 15 Hz and 15 +/- 30 Hz. BP was represented as mean arterial pressure (MAP). The level of coupling between the two physiological systems was estimated using linear and nonlinear methods such as correlation, coherence and mutual information. Causality of interaction was measured using transfer entropy. The illness severity was represented by the clinical risk index for babies (CRIB II score) and contrasted to the computed level of interaction. It is shown here that correlation and coherence, which are linear measures of the coupling between EEG and MAP, do not correlate with CRIB values, whereas adjusted mutual information, a nonlinear measure, is associated with CRIB scores (r = -0.57, p = 0.003). Mutual information is independent of the absolute values of MAP and EEG powers and quantifies the level of coupling between the short-term dynamics in both signals. The analysis indicated that the dominant causality is from changes in EEG producing changes in MAP. Transfer entropy (EEG to MAP) is associated with the CRIB score (0.3 +/- 3 Hz: r = 0.428, p = 0.033, 3 +/- 8 Hz: r = 0.44, p = 0.028, 8 +/- 15 Hz: r = 0.416, p = 0.038) and indicates that a higher level of directed coupling from brain activity to blood pressure is associated with increased illness in preterm infants. This is the first study to present the nonlinear measure of interaction between brain activity and blood pressure and to demonstrate its relation to the initial illness severity in the preterm infant. The obtained results allow us to hypothesise that the normal wellbeing of a preterm neonate can be characterised by a nonlinear coupling between brain activity and MAP, whereas the presence of weak coupling with distinctive directionality of information flow is associated with an increased mortality rate in preterms. en
dc.description.sponsorship Science Foundation Ireland (15/SIRG/3580) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science (PLoS) en
dc.relation.uri http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199587
dc.rights © 2018, Semenova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/
dc.subject Low-birth-weight en
dc.subject Information-theoretic measures en
dc.subject Fractional oxygen extraction en
dc.subject Cerebral electrical-activity en
dc.subject Mutual information en
dc.subject Premature-infants en
dc.subject Gestational-age en
dc.subject Activity transients en
dc.subject Spectral-analysis en
dc.subject Transfer entropy en
dc.title Coupling between mean blood pressure and EEG in preterm neonates is associated with reduced illness severity scores en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Oksana Semenova, Electrical and Electronic Engineering, University College Cork, Cork, Ireland. +353-21-490-3000 Email: o.semenova@umail.ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Science Foundation Ireland
dc.description.status Peer reviewed en
dc.identifier.journaltitle PLOS ONE en
dc.internal.IRISemailaddress o.semenova@umail.ucc.ie en
dc.identifier.articleid e0199587
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/


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© 2018, Semenova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as © 2018, Semenova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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