Networks of cortical activity show graded responses to perinatal asphyxia

Timo Syvälahti; Anna Tuiskula; Päivi Nevalainen; Marjo Metsäranta; Leena Haataja; Sampsa Vanhatalo; Anton Tokariev

doi:10.1038/s41390-023-02978-4

Networks of cortical activity show graded responses to perinatal asphyxia

Pediatr Res. 2023 Dec 22. doi: 10.1038/s41390-023-02978-4. Online ahead of print.

Authors

Timo Syvälahti^{1

2}, Anna Tuiskula^{3

4}, Päivi Nevalainen^{5

3}, Marjo Metsäranta^{3

4}, Leena Haataja⁶, Sampsa Vanhatalo^{5

3}, Anton Tokariev³

Affiliations

¹ Department of Clinical Neurophysiology, Children´s Hospital, and Epilepsia Helsinki, full member of ERN EpiCare, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland. timo.syvalahti@helsinki.fi.
² BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland. timo.syvalahti@helsinki.fi.
³ BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland.
⁴ Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland.
⁵ Department of Clinical Neurophysiology, Children´s Hospital, and Epilepsia Helsinki, full member of ERN EpiCare, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland.
⁶ Department of Pediatric Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland.

PMID: 38135725
DOI: 10.1038/s41390-023-02978-4

Abstract

Background: Perinatal asphyxia often leads to hypoxic-ischemic encephalopathy (HIE) with a high risk of neurodevelopmental consequences. While moderate and severe HIE link to high morbidity, less is known about brain effects of perinatal asphyxia with no or only mild HIE. Here, we test the hypothesis that cortical activity networks in the newborn infants show a dose-response to asphyxia.

Methods: We performed EEG recordings for infants with perinatal asphyxia/HIE of varying severity (n = 52) and controls (n = 53) and examined well-established computational metrics of cortical network activity.

Results: We found graded alterations in cortical activity networks according to severity of asphyxia/HIE. Furthermore, our findings correlated with early clinical recovery measured by the time to attain full oral feeding.

Conclusion: We show that both local and large-scale correlated cortical activity are affected by increasing severity of HIE after perinatal asphyxia, suggesting that HIE and perinatal asphyxia are better represented as a continuum rather than the currently used discreet categories. These findings imply that automated computational measures of cortical function may be useful in characterizing the dose effects of adversity in the neonatal brain; such metrics hold promise for benchmarking clinical trials via patient stratification or as early outcome measures.

Impact: Perinatal asphyxia causes every fourth neonatal death worldwide and provides a diagnostic and prognostic challenge for the clinician. We report that infants with perinatal asphyxia show specific graded responses in cortical networks according to severity of asphyxia and ensuing hypoxic-ischaemic encephalopathy. Early EEG recording and automated computational measures of brain function have potential to help in clinical evaluation of infants with perinatal asphyxia.