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      Technical standards for recording and interpretation of neonatal electroencephalogram in clinical practice

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          Abstract

          Neonatal electroencephalogram (EEG), though often perceived as being difficult to record and interpret, is relatively easy to study due to the immature nature of the brain, which expresses only a few well-defined set of patterns. The EEG interpreter needs to be aware of the maturational changes as well as the effect of pathological processes and medication on brain activity. It gives valuable information for the treatment and prognostication in encephalopathic neonates. In this group, serial EEGs or EEG monitoring often gives additional information regarding deterioration/improvement of the brain function or occurrence of seizures.

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          Early motor activity drives spindle bursts in the developing somatosensory cortex.

          Rustem Khazipov, Anton Sirota, Xavier Leinekugel … (2004)
          Sensorimotor coordination emerges early in development. The maturation period is characterized by the establishment of somatotopic cortical maps, the emergence of long-range cortical connections, heightened experience-dependent plasticity and spontaneous uncoordinated skeletal movement. How these various processes cooperate to allow the somatosensory system to form a three-dimensional representation of the body is not known. In the visual system, interactions between spontaneous network patterns and afferent activity have been suggested to be vital for normal development. Although several intrinsic cortical patterns of correlated neuronal activity have been described in developing somatosensory cortex in vitro, the in vivo patterns in the critical developmental period and the influence of physiological sensory inputs on these patterns remain unknown. We report here that in the intact somatosensory cortex of the newborn rat in vivo, spatially confined spindle bursts represent the first and only organized network pattern. The localized spindles are selectively triggered in a somatotopic manner by spontaneous muscle twitches, motor patterns analogous to human fetal movements. We suggest that the interaction between movement-triggered sensory feedback signals and self-organized spindle oscillations shapes the formation of cortical connections required for sensorimotor coordination.
          Article 0 comments Cited 171 times – based on 0 reviews     Review now
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            Development of neonatal EEG activity: from phenomenology to physiology.

            Sampsa Vanhatalo, Kai Kaila (2006)
            After having been in routine use for about half a century, neonatal EEG is currently facing unprecedented challenges in assessing and monitoring brain function during intensive care of preterm babies. It has therefore become increasingly important to understand the neurophysiological processes underlying EEG activity, as well as to identify those features of brain activity that are essential for brain development. By integrating the existing literature from basic neuroscience to neonatal EEG, the present review proposes a simple, neurophysiologically and neuroanatomically based framework for neonatal EEG interpretation. This is composed of two developmental trajectories: one related to discrete spontaneous activity transients (SAT) and the other to the ongoing, apparently oscillatory EEG activity. This framework can readily be applied to clinical use. It may open novel avenues to automated analysis in EEG monitoring and, moreover, it may facilitate genuine translational research.
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              Slow endogenous activity transients and developmental expression of K+-Cl- cotransporter 2 in the immature human cortex.

              Sture Andersson, Kai Kaila, Claudio Rivera … (2005)
              Spontaneous transients of correlated activity are a characteristic feature of immature brain structures, where they are thought to be crucial for the establishment of precise neuronal connectivity. Studies on experimental animals have shown that this kind of early activity in cortical structures is composed of long-lasting, intermittent network events, which undergo a developmental decline that is closely paralleled by the maturation of GABAergic inhibition. In order to examine whether similar events occur in the immature human cortex, we performed direct current-coupled electroencephalography (EEG) recordings from sleeping preterm babies. We show now that much of the preterm EEG activity is confined to spontaneous, slow activity transients. These transients are characterized by a large voltage deflection that nests prominent oscillatory activity in several frequency bands covering the whole frequency spectrum of the preterm EEG (<0.1-30 Hz). The slow voltage deflections had an amplitude of up to 800 microV. Most of these 'giant' events originated in the temporo-occipital areas, with a maximum rate of about 8/min, and their occurrence as well as amplitude showed a decline by the time of normal birth. In age-matched fetal brain tissue, this decrease in the spontaneous activity transients was associated with a developmental up-regulation of the neuronal chloride extruder K+-Cl- cotransporter 2, a crucial molecule for the generation of inhibitory GABAergic Cl- currents. Our work indicates that slow endogenous activity transients in the immature human neocortex are mostly confined to the prenatal stage and appear to be terminated in parallel with the maturation of functional GABAergic inhibition.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Indian Acad Neurol
                Journal ID (publisher-id): AIAN
                Title: Annals of Indian Academy of Neurology
                Publisher: Medknow Publications (India )
                ISSN (Print): 0972-2327
                ISSN (Electronic): 1998-3549
                Publication date (Print): Jan-Mar 2009
                Volume: 12
                Issue: 1
                Pages: 58-70
                Affiliations
                Departments of Clinical Neurophysiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
                [1 ]Departments of Neonatology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
                Author notes
                For correspondence: Perumpillichira J. Cherian, Department of Clinical Neurophysiology, Ba 404, Erasmus MC, Dr. Molewaterplein 40, 3015GD Rotterdam, The Netherlands. E-mail: j.perumpillichira@ 123456erasmusmc.nl
                Article
                Publisher ID: AIAN-12-58
                DOI: 10.4103/0972-2327.48869
                PMC ID: 2811985
                PubMed ID: 20151016
                SO-VID: 532bfd70-1c79-43a7-8c7d-837fb3a7ade0
                Copyright © © Annals of Indian Academy of Neurology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 09 September 2008
                Date revision received : 13 November 2008
                Date accepted : 19 November 2008
                Categories
                Subject: Technical Notes

                ScienceOpen disciplines: Neurology
                Keywords: hypoxic ischemic encephalopathy,electroencephalogram monitoring,neonatal seizures,amplitude integrated eeg,neonatal electroencephalogram
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: hypoxic ischemic encephalopathy, electroencephalogram monitoring, neonatal seizures, amplitude integrated eeg, neonatal electroencephalogram

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