Color density spectral array findings on continuous EEG during therapeutic hypothermia in children with acute encephalopathy

IF 1.4 4区 医学 Q4 CLINICAL NEUROLOGY
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Abstract

Background: Quantitative EEG is frequently used to monitor children affected by acute encephalopathy (AE), with the expectation of providing comprehensive insights into continuous EEG monitoring. However, the potential of quantitative EEG for estimating outcomes in this context remains unclear. We sought reliable prognostic markers within the color density spectral array (CDSA) of the continuous EEG for AE-affected children undergoing therapeutic hypothermia (TH). Methods: This retrospective study analyzed CDSA data from eight scalp electrodes of 15 AE-affected children undergoing TH. Two CDSA features were investigated—high-frequency lines (HFLs) and periodic elevation in the low frequency band (PLFB)—along with the corresponding EEG characteristics. The inter-rater reliability for CDSA was assessed by four pediatric neurologists. Outcomes were grouped into either no/mild or severe decline in motor and cognitive functions, then compared with CDSA features. Results: The median EEG recording time was 114 (81–151) h per child. While at least 41 % of HFLs corresponded to typical sleep spindles, 94 % of PLFB aligned with cyclic changes in the amplitude of delta/theta waves on the raw EEG. Inter-rater reliability was higher for HFLs than for PLFB (kappa values: 0.69 vs. 0.46). HFLs were significantly more prevalent in children with no/mild decline than in children with severe decline (p = 0.017), whereas PLFB did not differ significantly (p = 0.33). Conclusions: This study provides preliminary evidence that reduced HFLs on CDSA predict unfavorable outcomes in AE-affected children undergoing TH. This suggests that maintaining high-frequency waves is critical for optimal brain function.
急性脑病患儿治疗性低温期间连续脑电图的彩色密度谱阵列结果。
背景:定量脑电图经常用于监测受急性脑病(AE)影响的儿童,期望为连续脑电图监测提供全面的见解。然而,在这种情况下,定量脑电图在估计预后方面的潜力仍不明确。我们为接受治疗性低温(TH)的受 AE 影响的儿童寻找连续脑电图彩色密度谱阵列(CDSA)中可靠的预后标志物:这项回顾性研究分析了 15 名接受治疗性低温的 AE 受影响儿童的 8 个头皮电极的 CDSA 数据。研究了 CDSA 的两个特征--高频线(HFLs)和低频段周期性升高(PLFB)--以及相应的脑电图特征。四名儿科神经学家对 CDSA 的评分者间可靠性进行了评估。结果分为运动和认知功能无/轻度下降或严重下降,然后与 CDSA 特征进行比较:每个儿童的中位脑电图记录时间为 114 (81-151) h。至少 41% 的 HFLs 与典型的睡眠棘波相对应,而 94% 的 PLFB 与原始脑电图上 delta/theta 波振幅的周期性变化相对应。HFLs 的评分者间可靠性高于 PLFB(卡帕值:0.69 对 0.46)。HFLs在无/轻度衰退儿童中的发生率明显高于严重衰退儿童(p = 0.017),而PLFB则无明显差异(p = 0.33):本研究提供了初步证据,表明 CDSA 的高频率降低可预测接受 TH 的受 AE 影响儿童的不良预后。这表明,保持高频波对于优化大脑功能至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Brain & Development
Brain & Development 医学-临床神经学
CiteScore
3.60
自引率
0.00%
发文量
153
审稿时长
50 days
期刊介绍: Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.
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