Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage

Abstract

AbstractObjectiveIn healthy preterm infants, cortical burst rate and temporal dynamics predict important measures such as brain growth. We hypothesised that in preterm infants with germinal matrix-intraventricular haemorrhage (GM-IVH), cortical bursting could provide prognostic information. We determined how cortical bursting was influenced by the injury, and whether this was related to developmental outcome.MethodsWe identified 47 EEGs from 33 infants with GM-IVH ≥grade II (median gestational age: 25 weeks), acquired between 24-40 weeks corrected gestational age as part of routine clinical care. In a subset of 33 EEGs from 25 infants with asymmetric injury, we used the least-affected hemisphere as an internal control. We tested whether cortical burst rate predicted death or severe motor impairment (median 2 years follow-up; range 1-2 years corrected).ResultsGM-IVH depressed central cortical burst rate. Bursts over the worst-affected hemisphere were less likely to immediately follow (within 1 second) bursts over the least-affected hemisphere than vice versa. Lower burst rate was modestly associated with death or severe motor impairment (specificity 93%, sensitivity 37%).ConclusionsEEG can quantitatively index the functional injury after GM-IVH.SignificanceHigher cortical burst rate is reassuring for a positive motor outcome over the first 2 years.HighlightsGM-IVH depresses cortical burst rateGM-IVH unbalances inter-hemispheric burst dynamicsHigher burst rate following GM-IVH is associated with positive motor outcome at median 2 years