Abstract
BackgroundRecent studies explored the relationship between early brain function and brain morphology, based on the hypothesis that increased brain activity can positively affect structural brain development and that excitatory neuronal activity stimulates myelination.ObjectiveTo investigate the relationship between maturational features from early and serial aEEGs after premature birth and MRI metrics characterizing structural brain development and injury, measured around 30weeks postmenstrual age (PMA) and at term. Moreover, we aimed to verify whether previously developed maturational EEG features are related with PMA.Design/MethodsOne hundred six extremely preterm infants received bedside aEEGs during the first 72h and weekly until week 5. 3T-MRIs were performed at 30weeks PMA and at term. Specific features were extracted to assess EEG maturation: (1) the spectral content, (2) the continuity [percentage of spontaneous activity transients (SAT%) and the interburst interval (IBI)], and (3) the complexity. Automatic MRI segmentation to assess volumes and MRI score was performed. The relationship between the maturational EEG features and MRI measures was investigated.ResultsBoth SAT% and EEG complexity were correlated with PMA. IBI was inversely associated with PMA. Complexity features had a positive correlation with the cerebellar size at 30weeks, while event-based measures were related to the cerebellar size at term. Cerebellar width, cortical grey matter, and total brain volume at term were inversely correlated with the relative power in the higher frequency bands.ConclusionsThe continuity and complexity of the EEG steadily increase with increasing postnatal age. Increasing complexity and event-based features are associated with cerebellar size, a structure with enormous development during preterm life. Brain activity is important for later structural brain development.
Highlights
The immature brain of extremely preterm infants is prone to brain injury; monitoring and promoting optimal structural and functional brain development is key in the neonatal intensive care units (NICUs)
Recent literature explored the relationship between early brain function assessed via aEEG in the first postnatal days and brain morphology evaluated at term using magnetic resonance imaging (MRI) in the preterm population
A significant positive correlation between early brain activity, quantified using spontaneous activity transients (SATs) rate and cerebellar and cortical grey matter growth between 30 and 40 weeks post menstrual age (PMA), was observed, while a negative association was shown with interburst interval (IBI) [18]
Summary
The immature brain of extremely preterm infants is prone to brain injury; monitoring and promoting optimal structural and functional brain development is key in the neonatal intensive care units (NICUs).Electroencephalography (EEG) is an inexpensive and noninvasive tool widely used to perform long-term brainCerebellum (2021) 20:556–568 monitoring of preterm infants in the NICU. Recent literature explored the relationship between early brain function assessed via aEEG in the first postnatal days and brain morphology evaluated at term using MRI in the preterm population These studies hypothesized that increased brain activity can positively affect brain structural development and that excitatory neuronal activity stimulates myelination. SATs are intermittent high-amplitude bursts of activity, typically seen in the preterm infants’ EEG [14,15,16] They play a crucial role in human brain development, and their occurrence positively correlates to brain growth [17, 18]. A significant positive correlation between early brain activity, quantified using SAT rate and cerebellar and cortical grey matter growth between 30 and 40 weeks post menstrual age (PMA), was observed, while a negative association was shown with IBI [18]. Recent studies explored the relationship between early brain function and brain morphology, based on the hypothesis that increased brain activity can positively affect structural brain development and that excitatory neuronal activity stimulates myelination
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