早产儿脑电图的早期脑损伤特征

Signals Pub Date : 2023-09-06 DOI:10.3390/signals4030034
H. Abbasi, Malcolm R. Battin, Robyn Butler, Deborah Rowe, Benjamin A. Lear, A. Gunn, L. Bennet
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引用次数: 2

摘要

需要可靠的预后生物标志物来支持极早产儿脑损伤的早期诊断,并根据损伤的进展阶段制定有效的神经保护方案。实验和临床研究表明,神经元损伤的严重程度与缺氧缺血后脑电图的变化有关。我们之前曾报道过,在损伤发生之前,在早产儿羊的hi后记录的最初几个小时内,微尺度锐波脑电图波形具有预后价值。本文旨在研究这些细微的脑电图模式是否在生命早期的临床记录中转化为极早产儿。本研究评估了一组胎羊在HI后6小时(n = 7,妊娠103±1天)和极早产新生儿(n = 7,妊娠27±2.0周)出生后6小时的脑电图数据中自动识别的尖锐波的存在和形态相似性。我们报道,极早产儿出生后6小时前开始的记录中也存在与HI后胎羊相似的形态学和特征(r = 0.94)的微尺度脑电图波形。这项工作进一步表明,hi后的锐波表现出快速的形态进化,受年龄和/或神经元丢失严重程度的影响,因此自动化算法应该针对这种信号变化进行验证。最后,本文讨论了对早产儿早期脑电图变化进行更有针对性的研究的必要性,以帮助确定脑损伤的时间,识别生物标志物,从而有助于针对特定损伤阶段的新疗法。
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Early Signatures of Brain Injury in the Preterm Neonatal EEG
Reliable prognostic biomarkers are needed to support the early diagnosis of brain injury in extremely preterm infants, and to develop effective neuroprotective protocols that are tailored to the progressing phases of injury. Experimental and clinical research shows that severity of neuronal damage is correlated with changes in the electroencephalogram (EEG) after hypoxic-ischemia (HI). We have previously reported that micro-scale sharp-wave EEG waveforms have prognostic utility within the early hours of post-HI recordings in preterm fetal sheep, before injury develops. This article aims to investigate whether these subtle EEG patterns are translational in the early hours of life in clinical recordings from extremely preterm newborns. This work evaluates the existence and morphological similarity of the sharp-waves automatically identified throughout the entire duration of EEG data from a cohort of fetal sheep 6 h after HI (n = 7, at 103 ± 1 day gestation) and in recordings commencing before 6 h of life in extremely preterm neonates (n = 7, 27 ± 2.0 weeks gestation). We report that micro-scale EEG waveforms with similar morphology and characteristics (r = 0.94) to those seen in fetal sheep after HI are also present after birth in recordings started before 6 h of life in extremely preterm neonates. This work further indicates that the post-HI sharp-waves show rapid morphological evolution, influenced by age and/or severity of neuronal loss, and thus that automated algorithms should be validated against such signal variations. Finally, this article discusses the need for more focused research on the early assessment of EEG changes in preterm infants to help determine the timing of brain injury to identify biomarkers that could assist in targeting novel therapies for particular phases of injury.
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3.20
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审稿时长
11 weeks
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