title: Sleep-wake cycle on amplitude-integrated EEG and neuroimage outcomes in newborns.
abstract: BACKGROUND
  The aim of this study was to evaluate the results of sleep-wake cycle monitoring using amplitude-integrated EEG (aEEG) and neuroimaging in newborn infants with a possible perinatal hypoxic insult, investigate the correlation between the findings, and determine the relevance of the findings to reasonably predict neurological outcome.
  
  
  METHODS
  aEEG was recorded among newborn infants suspected of perinatal asphyxia between November, 2014 and June, 2015 in one neonatal intensive care unit facility. Brain imaging with serial ultrasonography and MRI when available were performed, and the infants were divided into two groups according to findings and potential neurological outcome: Group I (favorable findings) and Group II (severe findings such as high grade intraventricular hemorrhage, cerebral infarction or white matter injury). Established sleep-wake cycle times after birth was compared between the two groups.
  
  
  RESULTS
  Among 107 newborn infants, 85 subjects were classified as Group I and the remaining 22 subjects as Group II. The total number of aEEG sessions was 207 and recording time was 2,796 h with a mean of 14.43 ± 13.40 h per study. Estimated times of cyclicity were earlier in Group I (113.34 h, 95 % CI 82.31-144.37) as compared to Group II (504.39 h, 95 % CI 319.91-688.88; p < 0.001).
  
  
  CONCLUSIONS
  Delayed cyclicity on aEEG has a strong correlation with unfavorable brain neuroimages in newborns with possible perinatal asphyxia. If sleep-wake cycles do not appear during initial period after birth, follow-up aEEG studies are recommended.
  
  
  BACKGROUND
  Retrospectively registered Registration number: BD 2015-148 Name of registry: amplitude integrated EEG in neonate Date of registration: September 9, 2015.
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, South Korea.
authors.forename: Seonkyeong
authors.initials: S
authors.lastname: Rhie
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, South Korea.
authors.forename: Kyu Young
authors.initials: KY
authors.lastname: Chae
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, South Korea. joneona@cha.ac.kr.
authors.forename: Heui Seung
authors.initials: HS
authors.lastname: Jo
authors.affiliation: Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, South Korea.
authors.forename: Kyu Hyung
authors.initials: KH
authors.lastname: Lee
mesh_terms: D001238:Asphyxia Neonatorum / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D059906:Neuroimaging; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis*
keywords: Amplitude-integrated EEG; Cyclicity; Infant; Sleep-wake cycle; aEEG