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Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage

Koskela, T; Meek, J; Huertas-Ceballos, A; Kendall, GS; Whitehead, K; (2023) Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage. Early Human Development , 184 , Article 105840. 10.1016/j.earlhumdev.2023.105840. Green open access

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Abstract

Background: In 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. / Aims: We determined how cortical bursting was influenced by the injury, and whether this was related to developmental outcome. / Study design: Single-centre retrospective cohort study at University College London Hospitals, UK. / Subjects: 33 infants with GM-IVH ≥ grade II (median gestational age: 25 weeks). / Outcome measures: We identified 47 EEGs acquired between 24 and 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 comparison. We tested whether cortical burst rate predicted survival without severe impairment (median 2 years follow-up). / Results: In asymmetric injury, cortical burst rate was lower over the worst- than least-affected hemisphere, and bursts over the worst-affected hemisphere were less likely to immediately follow bursts over the least-affected hemisphere than vice versa. Overall, burst rate was lower in cases of GM-IVH with parenchymal involvement, relative to milder structural injury grades. Higher burst rate modestly predicted survival without severe language (AUC 0.673) or motor impairment (AUC 0.667), which was partly mediated by structural injury grade. / Conclusions: Cortical bursting can index the functional injury after GM-IVH: perturbed burst initiation (rate) and propagation (inter-hemispheric dynamics) likely reflect associated grey matter and white matter damage. Higher cortical burst rate is reassuring for a positive outcome.

Type: Article
Title: Clinical value of cortical bursting in preterm infants with intraventricular haemorrhage
Location: Ireland
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.earlhumdev.2023.105840
Publisher version: https://doi.org/10.1016/j.earlhumdev.2023.105840
Language: English
Additional information: Copyright © 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: Delta brushes, Developmental trajectory, IVH, Morphine, Spontaneous activity transients
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Div of Biosciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Div of Biosciences > Neuro, Physiology and Pharmacology
URI: https://discovery.ucl.ac.uk/id/eprint/10175757
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