Predictive value of electroencephalogram, event-related potential, and general movements quality assessment in neurodevelopmental outcome of high-risk infants.

OBJECTIVE: The objective of the study is to investigate the predictive value of electroencephalogram (EEG), event-related potential (ERP), and general movements (GMs) quality assessment in the neurodevelopmental outcome of high-risk infants at one year old. METHODS: EEG and ERP were performed in high-risk infants at four weeks old, and GMs quality was evaluated once at 4 weeks and once at 12 weeks. The Gesell score was used to assess neurodevelopment outcome at one year old. A comparative analysis of the effects of EEG, GMs, EEG + ERP, and EEG + ERP + GMs was used to predict high-risk neonatal neurodevelopmental outcome. RESULTS: Of 71 high-risk infants at the age of one year, 3 (4.23%) had cerebral palsy, 14 (19.72%) had psychomotor retardation, and 54 (76.05%) were normal. The sensitivity, specificity, positive predictive value, and negative predictive value of EEG + ERP + GMs method were 90.00%, 95.08%, 75.00%, and 98.31%, respectively, and these indexes were the highest among the four methods (EEG, GMs, EEG + ERP, and EEG + ERP + GMs). The kappa statistic for the reliability of predicting neurodevelopmental outcome of high risk newborns by the EEG + ERP + GMs method was substantial at 0.785, while the other three methods obtained relatively low Kappa values (0.599, 0.586, and 0.712, respectively). CONCLUSIONS: The combination of EEG, ERP, and GMs quality assessment can greatly improve the prediction of neurodevelopmental outcome of high-risk newborns.

Clinical significance of electroencephalography power spectrum density and functional connection analysis in neonates with hypoxic-ischemic encephalopathy.

OBJECTIVE: To investigate the effects of electroencephalography (EEG) power and functional connectivity analysis on cerebral cortex function in neonates with hypoxic-ischemic encephalopathy (HIE), and to identify the neurobiological indicators of neural development in HIE. METHODS: We recruited 20 mild HIE neonates, 15 moderate HIE neonates, and 30 controls. EEG was performed about 72 hr after birth. The power spectral density (PSD) and imaginary part of coherency (ICOH) were analyzed. Gesell developmental schedule (GDS) was used to evaluate the neural development in the mild and moderate HIE groups at 1 year of age, and the correlation between the quantitative EEG results and the state of neural development was analyzed. RESULTS: Compared with the controls, FP1, FP2, C3, C4, Fz, Cz, Pz , F3, and P4 of moderate HIE neonates showed that the PSD of theta, alpha and beta bands decreased significantly. In terms of the mean whole-brain PSD, the moderate HIE group showed a significant decrease in all frequency bands. ICOH of the moderate HIE group showed that functional connectivity was significantly less than that in the controls mainly in the delta band, and the functional connectivity of the delta, theta, alpha1, and alpha2 bands was markedly reduced compared with the mild HIE. GDS test at 1 year old showed that two infants in the moderate HIE group had suspected neurological delay in gross motor and language. The developmental quotient(DQ) of gross motor, language, and personal-social ability in the moderate HIE group were significantly lower than in the mild HIE group. And there was a significant positive correlation between PSD in each EEG frequency band and GDS score in the moderate HIE group. CONCLUSION: PSD and ICOH can be used to evaluate brain function. PSD can detect the delayed neurological development in infants with moderate HIE, and can be a neurobiomarker of brain development in HIE.