title: Changes in Cerebral Oxidative Metabolism during Neonatal Seizures Following Hypoxic-Ischemic Brain Injury.
abstract: Seizures are common following hypoxic-ischemic brain injury in newborn infants. Prolonged or recurrent seizures have been shown to exacerbate neuronal damage in the developing brain; however, the precise mechanism is not fully understood. Cytochrome-c-oxidase is responsible for more than 90% of ATP production inside mitochondria. Using a novel broadband near-infrared spectroscopy system, we measured the concentration changes in the oxidation state of cerebral cytochrome-c-oxidase (Δ[oxCCO]) and hemodynamics during recurrent neonatal seizures following hypoxic-ischemic encephalopathy in a newborn infant. A rapid increase in Δ[oxCCO] was noted at the onset of seizures along with a rise in the baseline of amplitude-integrated electroencephalogram. Cerebral oxygenation and cerebral blood volume fell just prior to the seizure onset but recovered rapidly during seizures. Δ[oxCCO] during seizures correlated with changes in mean electroencephalogram voltage indicating an increase in neuronal activation and energy demand. The progressive decline in the Δ[oxCCO] baseline during seizures suggests a progressive decrease of mitochondrial oxidative metabolism.
authors: Department of Neonatology, Institute for Women's Health, University College London , London , UK.
authors: Subhabrata
authors: S
authors: Mitra
authors: Department of Medical Physics and Biomedical Engineering, University College London , London , UK.
authors: Gemma
authors: G
authors: Bale
authors: Department of Neonatology, Institute for Women's Health, University College London , London , UK.
authors: Sean
authors: S
authors: Mathieson
authors: Department of Neonatology, Institute for Women's Health, University College London , London , UK.
authors: Cristina
authors: C
authors: Uria-Avellanal
authors: Department of Neonatology, Institute for Women's Health, University College London , London , UK.
authors: Judith
authors: J
authors: Meek
authors: Department of Medical Physics and Biomedical Engineering, University College London , London , UK.
authors: Ilias
authors: I
authors: Tachtsidis
authors: Department of Neonatology, Institute for Women's Health, University College London , London , UK.
authors: Nicola J
authors: NJ
authors: Robertson
keywords: cytochrome-c-oxidase; electroencephalography; hypoxic–ischemic encephalopathy; near-infrared spectroscopy; seizures