Multichannel EEG abnormalities during the first 6 hours in infants with mild hypoxic-ischaemic encephalopathy

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dc.contributor.authorGarvey, Aisling A.
dc.contributor.authorPavel, Andreea
dc.contributor.authorO'Toole, John M.
dc.contributor.authorWalsh, Brian
dc.contributor.authorKorotchikova, Irina
dc.contributor.authorLivingstone, Vicki
dc.contributor.authorDempsey, Eugene M.
dc.contributor.authorMurray, Deirdre M.
dc.contributor.authorBoylan, Geraldine B.
dc.contributor.funderScience Foundation Irelanden
dc.contributor.funderMolecular Medicine Irelanden
dc.contributor.funderHealth Research Boarden
dc.contributor.funderNational Children’s Research Centreen
dc.contributor.funderWellcome Trusten
dc.date.accessioned2022-04-26T08:55:09Z
dc.date.available2022-04-26T08:55:09Z
dc.date.issued2021-07
dc.date.updated2022-04-25T14:03:06Z
dc.description.abstractBackground: Infants with mild HIE are at risk of significant disability at follow-up. In the pre-therapeutic hypothermia (TH) era, electroencephalography (EEG) within 6 hours of birth was most predictive of outcome. This study aims to identify and describe features of early EEG and heart rate variability (HRV) (<6 hours of age) in infants with mild HIE compared to healthy term infants. Methods: Infants >36 weeks with mild HIE, not undergoing TH, with EEG before 6 hours of age were identified from 4 prospective cohort studies conducted in the Cork University Maternity Services, Ireland (2003-2019). Control infants were taken from a contemporaneous study examining brain activity in healthy term infants. EEGs were qualitatively analysed by two neonatal neurophysiologists and quantitatively assessed using multiple features of amplitude, spectral shape and inter-hemispheric connectivity. Quantitative features of HRV were assessed in both the groups. Results: Fifty-eight infants with mild HIE and sixteen healthy term infants were included. Seventy-two percent of infants with mild HIE had at least one abnormal EEG feature on qualitative analysis and quantitative EEG analysis revealed significant differences in spectral features between the two groups. HRV analysis did not differentiate between the groups. Conclusions: Qualitative and quantitative analysis of the EEG before 6 hours of age identified abnormal EEG features in mild HIE, which could aid in the objective identification of cases for future TH trials in mild HIE. Impact: Infants with mild HIE currently do not meet selection criteria for TH yet may be at risk of significant disability at follow-up. In the pre-TH era, EEG within 6 hours of birth was most predictive of outcome; however, TH has delayed this predictive value. 72% of infants with mild HIE had at least one abnormal EEG feature in the first 6 hours on qualitative assessment. Quantitative EEG analysis revealed significant differences in spectral features between infants with mild HIE and healthy term infants. Quantitative EEG features may aid in the objective identification of cases for future TH trials in mild HIE.en
dc.description.sponsorshipMolecular Medicine Ireland (Clinician Scientist Fellowship); Health Research Board (Grant number CSA/2012/40); National Children’s Research Centre (Clinical Fellowship award D/18/6); Science Foundation Ireland (Grant numnbers 15/SIRG/3580 and 18/TIDA/6166)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationGarvey, A. A., Pavel, A., O'Toole, J. M., Walsh, B., Korotchikova, I., Livingstone, V., Dempsey, E. M., Murray, D. M. and Boylan, Geraldine B. (2021) 'Multichannel EEG abnormalities during the first 6 hours in infants with mild hypoxic-ischaemic encephalopathy', Pediatric Research, 90 (1), pp. 117-124. doi: 10.1038/s41390-021-01412-xen
dc.identifier.doi10.1038/s41390-021-01412-xen
dc.identifier.endpage124en
dc.identifier.issn0031-3998
dc.identifier.issued1en
dc.identifier.journaltitlePediatric Researchen
dc.identifier.startpage117en
dc.identifier.urihttps://hdl.handle.net/10468/13116
dc.identifier.volume90en
dc.language.isoenen
dc.publisherSpringer Natureen
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/en
dc.relation.projectinfo:eu-repo/grantAgreement/WT/Innovations/098983//Multicentre Clinical evaluation of a neonatal seizure detection algorithm./en
dc.rights© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectAmplitude-integrated EEGen
dc.subjectHeart-rate-variabilityen
dc.subjectShort-term outcomesen
dc.subjectFull-termen
dc.subjectSystemic hypothermiaen
dc.subjectTherapeutic hypothermiaen
dc.subjectNeonatal encephalopathyen
dc.subjectPredictive-valueen
dc.subjectNewbornsen
dc.subjectElectroencephalographyen
dc.titleMultichannel EEG abnormalities during the first 6 hours in infants with mild hypoxic-ischaemic encephalopathyen
dc.typeArticle (peer-reviewed)en
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