Quantitative EEG features during the first day correlate to clinical outcome in perinatal asphyxia

Anna Tuiskula; Alexey S Pospelov; Päivi Nevalainen; Saeed Montazeri; Marjo Metsäranta; Leena Haataja; Nathan Stevenson; Anton Tokariev; Sampsa Vanhatalo

doi:10.1038/s41390-024-03235-y

Quantitative EEG features during the first day correlate to clinical outcome in perinatal asphyxia

Pediatr Res. 2024 May 14. doi: 10.1038/s41390-024-03235-y. Online ahead of print.

Authors

Anna Tuiskula^{1

2}, Alexey S Pospelov^{3

4}, Päivi Nevalainen^{3

5}, Saeed Montazeri^{3

4}, Marjo Metsäranta^{6

3}, Leena Haataja^{3

7}, Nathan Stevenson⁸, Anton Tokariev^{3

4}, Sampsa Vanhatalo^{3

4

5}

Affiliations

¹ Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. anna.tuiskula@hus.fi.
² BABA Center, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. anna.tuiskula@hus.fi.
³ BABA Center, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁴ Department of Physiology, University of Helsinki, Helsinki, Finland.
⁵ Department of Clinical Neurophysiology, Children's Hospital, HUS Diagnostic Center, and Epilepsia Helsinki, full member of ERN EpiCare University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁶ Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁷ Department of Pediatric Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁸ Brain Modelling Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.

PMID: 38745028
DOI: 10.1038/s41390-024-03235-y

Abstract

Objective: To assess whether computational electroencephalogram (EEG) measures during the first day of life correlate to clinical outcomes in infants with perinatal asphyxia with or without hypoxic-ischemic encephalopathy (HIE).

Methods: We analyzed four-channel EEG monitoring data from 91 newborn infants after perinatal asphyxia. Altogether 42 automatically computed amplitude- and synchrony-related EEG features were extracted as 2-hourly average at very early (6 h) and early (24 h) postnatal age; they were correlated to the severity of HIE in all infants, and to four clinical outcomes available in a subcohort of 40 newborns: time to full oral feeding (nasogastric tube NGT), neonatal brain MRI, Hammersmith Infant Neurological Examination (HINE) at three months, and Griffiths Scales at two years.

Results: At 6 h, altogether 14 (33%) EEG features correlated significantly to the HIE grade ([r]= 0.39-0.61, p < 0.05), and one feature correlated to NGT ([r]= 0.50). At 24 h, altogether 13 (31%) EEG features correlated significantly to the HIE grade ([r]= 0.39-0.56), six features correlated to NGT ([r]= 0.36-0.49) and HINE ([r]= 0.39-0.61), while no features correlated to MRI or Griffiths Scales.

Conclusions: Our results show that the automatically computed measures of early cortical activity may provide outcome biomarkers for clinical and research purposes.

Impact: The early EEG background and its recovery after perinatal asphyxia reflect initial severity of encephalopathy and its clinical recovery, respectively. Computational EEG features from the early hours of life show robust correlations to HIE grades and to early clinical outcomes. Computational EEG features may have potential to be used as cortical activity biomarkers in early hours after perinatal asphyxia.