Differences in impaired brainstem conduction between neonatal chronic lung disease and perinatal asphyxia

Abstract

To explore any differences in impaired brainstem function between preterm infants with neonatal chronic lung disease (CLD) and term infants after perinatal asphyxia. Brainstem auditory evoked responses (BAERs) collected using maximum length sequence (MLS) technique were compared at term equivalent age between 43 CLD infants and 117 asphyxiated infants. In both CLD and asphyxiated infants there was a significant increase in wave V latency and I-V interval in MLS BAER. CLD infants showed a significant increased III-V interval but a normal I-III interval at all click rates. However, asphyxiated infants showed a significant increase in both III-V and I-III intervals. I-III interval was shorter and III-V/I-III interval ratio was greater in CLD infants than in asphyxiated infants. The slope of I-III interval-rate function was steeper in asphyxiated infants than in CLD infants, while the slope of III-V/I-III interval ratio-rate function was the other way around. CLD infants had a major increase in more central components of MLS BAER, without appreciable abnormality in more peripheral components. However, asphyxiated infants had a significant increase in both central and peripheral components. Neonatal CLD affects more central regions of the brainstem, whereas perinatal asphyxia affects both peripheral and central regions. This difference, which is likely related to the different nature of hypoxia in CLD and asphyxia, may have some significance for neuroprotective interventions for the two problems.