Päivi Nevalainen1, Petri Rahkonen2, Elina Pihko3, Aulikki Lano4, Sampsa Vanhatalo5, Sture Andersson2, Taina Autti6, Leena Valanne6, Marjo Metsäranta2, Leena Lauronen7. 1. BioMag Laboratory, Hospital District of Helsinki and Uusimaa, HUS Medical Imaging Center, Helsinki University Central Hospital (HUCH), Helsinki, Finland; Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, HUCH, University of Helsinki, Helsinki, Finland. Electronic address: paivi.nevalainen@helsinki.fi. 2. Department of Pediatrics, Children's Hospital, HUCH, University of Helsinki, Helsinki, Finland. 3. Brain Research Unit, O.V. Lounasmaa Laboratory, Aalto University School of Science, Espoo, Finland. 4. Department of Child Neurology, Children's Hospital, HUCH, University of Helsinki, Helsinki, Finland. 5. Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, HUCH, University of Helsinki, Helsinki, Finland. 6. Department of Radiology, HUS Medical Imaging Center, HUCH, Helsinki, Finland. 7. BioMag Laboratory, Hospital District of Helsinki and Uusimaa, HUS Medical Imaging Center, Helsinki University Central Hospital (HUCH), Helsinki, Finland; Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, HUCH, University of Helsinki, Helsinki, Finland.
Abstract
OBJECTIVE: Prior studies on extremely preterm infants have reported long-term prognostic value of absent secondary somatosensory cortex (SII) responses in magnetoencephalography (MEG) at term. The present work (i) further examines the potential added value of SII responses in neonatal neurological evaluation of preterm infants, and (ii) tests whether SII responses are detectable in routine neonatal electroencephalogram complemented with median nerve stimulation (EEG-SEP). METHODS: Altogether 29 infants born <28 gestational weeks underwent MEG, MRI, and neonatal neurological examination at term age, and Hempel neurological examination at 2-years corrected age. Term-age EEG-SEP was available for seven infants. RESULTS: While in neonatal neurological examination severely abnormal finding predicted unfavorable outcome in 2/2 infants, outcome was unfavorable also in 3/9 (33%) moderately abnormal and in 5/18 (28%) mildly abnormal/normal infants. Of these eight infants four had unilaterally absent SII responses in MEG, compared with only two of the 24 infants with favorable outcome. Furthermore, SII responses (when present in MEG) were also usually detectable in EEG-SEP. CONCLUSIONS: Complementing clinical EEG recording with SEP holds promise for valuable extension of neonatal neurophysiological assessment. SIGNIFICANCE: Multimodal study of EEG and sensory evoked responses is informative, safe, and cheap, and it can be readily performed at bedside.
OBJECTIVE: Prior studies on extremely preterm infants have reported long-term prognostic value of absent secondary somatosensory cortex (SII) responses in magnetoencephalography (MEG) at term. The present work (i) further examines the potential added value of SII responses in neonatal neurological evaluation of preterm infants, and (ii) tests whether SII responses are detectable in routine neonatal electroencephalogram complemented with median nerve stimulation (EEG-SEP). METHODS: Altogether 29 infants born <28 gestational weeks underwent MEG, MRI, and neonatal neurological examination at term age, and Hempel neurological examination at 2-years corrected age. Term-age EEG-SEP was available for seven infants. RESULTS: While in neonatal neurological examination severely abnormal finding predicted unfavorable outcome in 2/2 infants, outcome was unfavorable also in 3/9 (33%) moderately abnormal and in 5/18 (28%) mildly abnormal/normal infants. Of these eight infants four had unilaterally absent SII responses in MEG, compared with only two of the 24 infants with favorable outcome. Furthermore, SII responses (when present in MEG) were also usually detectable in EEG-SEP. CONCLUSIONS: Complementing clinical EEG recording with SEP holds promise for valuable extension of neonatal neurophysiological assessment. SIGNIFICANCE: Multimodal study of EEG and sensory evoked responses is informative, safe, and cheap, and it can be readily performed at bedside.
Authors: Yu-Han Chen; Joni Saby; Emily Kuschner; William Gaetz; J Christopher Edgar; Timothy P L Roberts Journal: Neuroimage Date: 2019-01-24 Impact factor: 6.556
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