title: Delayed cyclic activity development on early amplitude-integrated EEG in the preterm infant with brain lesions.
abstract: BACKGROUND
  Maturation of amplitude-integrated electroencephalogram (aEEG) activity is influenced by both gestational age (GA) and postmenstrual age. It is not fully known how this process is influenced by cerebral lesions.
  
  
  OBJECTIVE
  To compare early aEEG developmental changes between preterm newborns with different degrees of cerebral lesions on cranial ultrasound (cUS).
  
  
  METHODS
  Prospective cohort study on preterm newborns with GA <32.0 weeks, undergoing continuous aEEG recording during the first 84 h after birth. aEEG characteristics were qualitatively and quantitatively evaluated using pre-established criteria. Based on cUS findings three groups were formed: normal (n = 78), mild (n = 20), and severe cerebral lesions (n = 6). Linear mixed models for repeated measures were used to analyze aEEG maturational trajectories.
  
  
  RESULTS
  104 newborns with a mean GA (range) 29.5 (24.4-31.7) weeks, and birth weight 1,220 (580-2,020) g were recruited. Newborns with severe brain lesions started with similar aEEG scores and tendentially lower aEEG amplitudes than newborns without brain lesions, and showed a slower development of the cyclic activity (p < 0.001), but a more rapid increase of the maximum and minimum aEEG amplitudes (p = 0.002 and p = 0.04).
  
  
  CONCLUSIONS
  Preterm infants with severe cerebral lesions manifest a maturational delay in the aEEG cyclic activity already early after birth, but show a catch-up of aEEG amplitudes to that of newborns without cerebral lesions. Changes in the maturational aEEG pattern may be a marker of severe neurological lesions in the preterm infant.
authors.affiliation: Department of Neonatology, University Hospital, University Children's Hospital Zurich, Zurich, Switzerland. giancarlo.natalucci@usz.ch
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Natalucci
authors.forename: Valentin
authors.initials: V
authors.lastname: Rousson
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Bucher
authors.forename: Vera
authors.initials: V
authors.lastname: Bernet
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hagmann
authors.forename: Beatrice
authors.initials: B
authors.lastname: Latal
mesh_terms: D001927:Brain Diseases / Q000503:physiopathology*; D015331:Cohort Studies; D004569:Electroencephalography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D007235:Infant, Premature, Diseases / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies