ABSTRACT
OBJECTIVE: To investigate how functional integrity of ascending sensory pathways measured by visual and somatosensory evoked potentials (VEP & SEP) is associated with abnormal glycemia and brain injury in newborns treated with hypothermia for hypoxic-ischemic encephalopathy (HIE). METHODS: Fifty-four neonates ≥ 36 weeks gestational age with HIE underwent glucose testing, VEPs, SEPs, and magnetic resonance imaging (MRI) the first week of life. Minimum and maximum glucose values recorded prior to evoked potential (EP) testing were compared with VEP and SEP measures using generalized estimating equations. Relationships between VEP and SEP measures and brain injury on MRI were assessed. RESULTS: Maximum glucose is associated with decreased P200 amplitude, and increased odds that N300 peak will be delayed/absent. Minimum glucose is associated with decreased P22 amplitude. Presence of P200 and N300 peaks is associated with decreased odds of brain injury in the visual processing pathway, with delayed/absent N300 peak associated with increased odds of brain injury in posterior white matter. CONCLUSIONS: Deviations from normoglycemia are associated with abnormal EPs, and abnormal VEPs are associated with brain injury on MRI in cooled neonates with HIE. SIGNIFICANCE: Glucose is a modifiable risk factor associated with atypical brain function in neonates with HIE despite hypothermia treatment.
Subject(s)
Asphyxia Neonatorum/physiopathology , Evoked Potentials/physiology , Hyperglycemia/physiopathology , Hypoglycemia/physiopathology , Hypoxia-Ischemia, Brain/physiopathology , Asphyxia Neonatorum/diagnostic imaging , Electroencephalography , Female , Humans , Hyperglycemia/diagnostic imaging , Hypoglycemia/diagnostic imaging , Infant, Newborn , Magnetic Resonance Imaging , MaleABSTRACT
Neurophysiological studies, including electroencephalography (EEG) and evoked potentials (EPs), are helpful bedside tools for assessing neurologic function and helping with prediction of long-term neurodevelopmental outcomes following brain injury in preterm and term newborns. In this chapter, we describe the use of electroencephalography, including both amplitude-integrated EEG and continuous video EEG, and EPs, including visual, somatosensory, and brainstem auditory EPs, in the neonatal period. We review the current literature on the utility of these neurophysiological studies in the prediction of long-term outcomes in preterm and term newborns.
