Sarah B Mulkey1,2,3, Laura Hitchings4, Reva Persaud4, Srinivas Kota4, G Larry Maxwell5, Robin Baker5,6, Adre du Plessis4,7,8, Rathinaswamy Govindan4,7. 1. Children's National Hospital, Prenatal Pediatrics Institute, 111 Michigan Ave., NW, Washington, DC, 20010, USA. sbmulkey@childrensnational.org. 2. Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. sbmulkey@childrensnational.org. 3. Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. sbmulkey@childrensnational.org. 4. Children's National Hospital, Prenatal Pediatrics Institute, 111 Michigan Ave., NW, Washington, DC, 20010, USA. 5. Inova Women's and Children's Hospital, Falls Church, VA, USA. 6. Fairfax Neonatal Associates, Fairfax, VA, USA. 7. Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. 8. Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Abstract
PURPOSE: The mature central autonomic network includes connectivity between autonomic nervous system brainstem centers and the cerebral cortex. The study objective was to evaluate the regional connectivity between the cerebral cortex and brainstem autonomic centers in term newborns by measuring coherence between high-density electroencephalography and heart rate variability as measured by electrocardiography. METHODS: Low-risk term newborns with birth gestational age of 39-40 weeks were prospectively enrolled and studied using time-synced electroencephalography and electrocardiography for up to 60 min before discharge from the birth hospital. The ccortical autonomicc nervous system association was analyzed using coherence between electroencephalography-delta power and heart rate variability. Heart rate variability measured the parasympathetic tone (root mean square of successive differences of heart rate) and sympathetic tone (standard deviation of heart rate). RESULTS: One hundred and twenty-nine low-risk term infants were included. High coherence delta-root mean square of successive differences was found in central, bitemporal, and occipital brain regions, with less robust coherence delta-standard deviation in the central region and bitemporal areas. CONCLUSIONS: Our findings describe a topography of ccortical autonomicc connectivity present at term in low-risk newborns, which was more robust to parasympathetic than sympathetic brainstem centers and was independent of newborn state.
PURPOSE: The mature central autonomic network includes connectivity between autonomic nervous system brainstem centers and the cerebral cortex. The study objective was to evaluate the regional connectivity between the cerebral cortex and brainstem autonomic centers in term newborns by measuring coherence between high-density electroencephalography and heart rate variability as measured by electrocardiography. METHODS: Low-risk term newborns with birth gestational age of 39-40 weeks were prospectively enrolled and studied using time-synced electroencephalography and electrocardiography for up to 60 min before discharge from the birth hospital. The ccortical autonomicc nervous system association was analyzed using coherence between electroencephalography-delta power and heart rate variability. Heart rate variability measured the parasympathetic tone (root mean square of successive differences of heart rate) and sympathetic tone (standard deviation of heart rate). RESULTS: One hundred and twenty-nine low-risk term infants were included. High coherence delta-root mean square of successive differences was found in central, bitemporal, and occipital brain regions, with less robust coherence delta-standard deviation in the central region and bitemporal areas. CONCLUSIONS: Our findings describe a topography of ccortical autonomicc connectivity present at term in low-risk newborns, which was more robust to parasympathetic than sympathetic brainstem centers and was independent of newborn state.
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