title: Mapping cortical haemodynamics during neonatal seizures using diffuse optical tomography: a case study.
abstract: Seizures in the newborn brain represent a major challenge to neonatal medicine. Neonatal seizures are poorly classified, under-diagnosed, difficult to treat and are associated with poor neurodevelopmental outcome. Video-EEG is the current gold-standard approach for seizure detection and monitoring. Interpreting neonatal EEG requires expertise and the impact of seizures on the developing brain remains poorly understood. In this case study we present the first ever images of the haemodynamic impact of seizures on the human infant brain, obtained using simultaneous diffuse optical tomography (DOT) and video-EEG with whole-scalp coverage. Seven discrete periods of ictal electrographic activity were observed during a 60 minute recording of an infant with hypoxic-ischaemic encephalopathy. The resulting DOT images show a remarkably consistent, high-amplitude, biphasic pattern of changes in cortical blood volume and oxygenation in response to each electrographic event. While there is spatial variation across the cortex, the dominant haemodynamic response to seizure activity consists of an initial increase in cortical blood volume prior to a large and extended decrease typically lasting several minutes. This case study demonstrates the wealth of physiologically and clinically relevant information that DOT-EEG techniques can yield. The consistency and scale of the haemodynamic responses observed here also suggest that DOT-EEG has the potential to provide improved detection of neonatal seizures.
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
authors.forename: Harsimrat
authors.initials: H
authors.lastname: Singh
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Cooper
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
authors.forename: Chuen
authors.initials: C
authors.lastname: Wai Lee
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Dempsey
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Edwards
authors.affiliation: Department of Developmental Psychology, University of Padova, Padova, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Brigadoi
authors.affiliation: Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Airantzis
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Everdell
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Neurophysiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Michell
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
authors.forename: David
authors.initials: D
authors.lastname: Holder
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
authors.forename: Jeremy C
authors.initials: JC
authors.lastname: Hebden
authors.affiliation: neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
authors.forename: Topun
authors.initials: T
authors.lastname: Austin
mesh_terms: D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods*; D004569:Electroencephalography; D006439:Hemodynamics; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000503:physiopathology; D007090:Image Interpretation, Computer-Assisted; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology; D012815:Signal Processing, Computer-Assisted; D019265:Spectroscopy, Near-Infrared; D041622:Tomography, Optical / Q000379:methods*
keywords: Diffuse optical tomography (DOT); Functional near infrared spectroscopy (fNIRS); Hypoxic–ischaemic encephalopathy (HIE); Neonatal seizures