1
|
Takeuchi A, Inoue T, Nakamura M, Kageyama M, Akiyama T, Kobayashi K. Case Report: High-Gamma Oscillations on an Ictal Electroencephalogram in a Newborn Patient With Hypoxic-Ischemic Encephalopathy. Front Pediatr 2021; 9:679771. [PMID: 34660474 PMCID: PMC8518698 DOI: 10.3389/fped.2021.679771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/17/2021] [Indexed: 11/13/2022] Open
Abstract
Fast oscillations (FOs) >40 Hz in electroencephalograms (EEGs) are associated with ictogenesis and epileptogenesis in adults and children with epilepsy. However, only a few previous studies showed FOs in neonates. Reported frequencies of such neonatal FOs were in the low-gamma (<60 Hz) band and, therefore, they were not high compared to those in pediatric patients. We herein report a newborn patient with severe hypoxic-ischemic encephalopathy (HIE), who showed pathological FOs with a frequency in the high-gamma band. She was born at a gestational age of 39 weeks 4 days by emergency cesarean section because of non-reassuring fetal status. She had focal motor seizures involving unilateral upper and lower limbs lasting for tens of seconds on days 0, 1, 4, 5, 8, and 9 and subclinical seizures on days 4-11. Phenobarbital (PB) was intravenously administered on days 0, 2, 4, 5, and 6. We found FOs that were superimposed on the ictal delta activities using visual inspection and time-frequency analysis on 8-11 days of age. Among them, we detected high-gamma (71.4-100 Hz) oscillations that appeared to be temporally independent of low-gamma activities in the ictal EEG on 11 days of age. To the best of our knowledge, this is one of the earliest reports showing pathological FOs with a frequency of >60 Hz in the high-gamma band in human neonatal seizures, which were previously observed in animal studies. Further studies are needed to elucidate the pathophysiology of ictal FOs in neonatal seizures.
Collapse
Affiliation(s)
- Akihito Takeuchi
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan.,Division of Child Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Takushi Inoue
- Division of Child Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Makoto Nakamura
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Misao Kageyama
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Tomoyuki Akiyama
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Katsuhiro Kobayashi
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| |
Collapse
|
2
|
Shibata T, Otsubo H. Phase-amplitude coupling of delta brush unveiling neuronal modulation development in the neonatal brain. Neurosci Lett 2020; 735:135211. [PMID: 32593774 DOI: 10.1016/j.neulet.2020.135211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/15/2020] [Accepted: 06/24/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Delta brushes are an indicator of brain maturity on a neonatal EEG. We investigated phase-amplitude coupling (PAC) between slow delta waves and superimposed alpha-beta activity in delta brushes to elucidate the spatiotemporal developments of the delta brush with post-menstrual weeks (PMW). METHODS The subjects were 18 neurologically intact patients (seven girls). We analyzed EEG within 42 PMW. Patients were divided into four age groups as follows: PMW ≤30w; 31-34 w; 35-38 w; and 39-42 w. We selected up to three epochs of 2-minute EEG segments including delta brushes. We calculated the modulation index (MI), direct mean vector length (dMVL), and mean of phase angle of coupling by PAC between slow waves (0.5-1.5 Hz) and fast activities (8-25 Hz) in four regions (F: Fp1 and Fp2, C: C3 and C4, T: T3 and T4, O: O1 and O2). RESULTS We collected data from 18 patients and 31 epochs between 29 and 42 PMW, which comprised one, four, five, and eight patients, and two, seven, eight, and 14 epochs in the ≤30w, 31-34 w, 35-38 w, and 39-42 w groups, respectively. There were significant differences in the dMVL between the four regions in age groups ≤30w (P = 0.033) and 31-34w (0.017). Both MI and dMVL showed that delta brushes became higher in the occipital region from 32 to 36 PMW. The mean phase angle of coupling concentrated around either 0° or 180° for all age groups. CONCLUSIONS PAC analysis revealed the spatiotemporal relations of alpha-beta activities that are modulated by slow delta waves in neonatal delta brushes. The delta brushes appeared to be at a maximum around 32-36 PMW with the predominant occipital distribution. The PAC of the delta brush might represent the cortical neuronal fast activity that is modulated by slow delta waves of subcortical regions during a particular neonatal period.
Collapse
Affiliation(s)
- Takashi Shibata
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hiroshi Otsubo
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
| |
Collapse
|
3
|
Grieve PG, Fifer WP, Cousy NP, Monk CE, Stark RI, Gingrich JA, Myers MM. Neonatal infant EEG bursts are altered by prenatal maternal depression and serotonin selective reuptake inhibitor use. Clin Neurophysiol 2019; 130:2019-2025. [PMID: 31539768 DOI: 10.1016/j.clinph.2019.08.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/03/2019] [Accepted: 08/24/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Increasingly, serotonin selective reuptake inhibitor (SSRI) medications are prescribed in pregnancy. These medications pass freely into the developing fetus but little is known about their effect on brain development in humans. In this study we determine if prenatal maternal depression and SSRI medication change the EEG infant delta brush bursts which are an early marker of normal brain maturation. METHODS We measured delta brush bursts from the term infants of three groups of mothers (controls (N = 52), depressed untreated (N = 15), and those taking serotonin SSRI medication (N = 10). High density EEGs were obtained during sleep at an average age of 44 weeks post conceptional age. We measured the rate of occurrence, brush amplitude, oscillation frequency and duration of the bursts. RESULTS Compared to infants of control mothers, the parameters of delta brush bursts of the offspring of depressed and SSRI-using mothers are significantly altered: burst amplitude is decreased; the oscillation frequency increased, and the duration increased (SSRI only). These significant differences were found during both sleep states. CONCLUSIONS Electrocortical bursting activity (i.e. delta brushes) is known to play an important role in early central nervous system (CNS) synaptic formation and function. SIGNIFICANCE Maternal depression or SSRI use may alter brain function in their offspring.
Collapse
Affiliation(s)
- P G Grieve
- Department of Pediatrics, Columbia University, New York, NY 10032, USA.
| | - W P Fifer
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - N P Cousy
- Cape Services, 22 rue Pierre Mendès, Torcy 77200, France
| | - C E Monk
- Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA
| | - R I Stark
- Department of Pediatrics, Columbia University, New York, NY 10032, USA
| | - J A Gingrich
- Columbia University Medical Center, Psychiatry, New York, NY 10032, USA
| | - M M Myers
- Columbia University Medical Center, Psychiatry, New York, NY 10032, USA
| |
Collapse
|
4
|
de Camp NV, Hense F, Lecher B, Scheu H, Bergeler J. Models for Preterm Cortical Development Using Non Invasive Clinical EEG. Transl Neurosci 2018; 8:211-224. [PMID: 29445543 PMCID: PMC5811640 DOI: 10.1515/tnsci-2017-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 09/20/2017] [Indexed: 01/14/2023] Open
Abstract
The objective of this study was to evaluate the piglet and the mouse as model systems for preterm cortical development. According to the clinical context, we used non invasive EEG recordings. As a prerequisite, we developed miniaturized Ag/AgCl electrodes for full band EEG recordings in mice and verified that Urethane had no effect on EEG band power. Since mice are born with a “preterm” brain, we evaluated three age groups: P0/P1, P3/P4 and P13/P14. Our aim was to identify EEG patterns in the somatosensory cortex which are distinguishable between developmental stages and represent a physiologic brain development. In mice, we were able to find clear differences between age groups with a simple power analysis of EEG bands and also for phase locking and power spectral density. Interhemispheric coherence between corresponding regions can only be seen in two week old mice. The canolty maps for piglets as well as for mice show a clear PAC (phase amplitude coupling) pattern during development. From our data it can be concluded that analytic tools relying on network activity, as for example PAC (phase amplitude coupling) are best suited to extract basic EEG patterns of cortical development across species.
Collapse
Affiliation(s)
- Nora Vanessa de Camp
- Medical Center of the Johannes Gutenberg, University Mainz, Mainz, Germany.,Free University Berlin, Berlin, Germany.,Humboldt University Berlin, Berlin, Germany
| | - Florian Hense
- Medical Center of the Johannes Gutenberg, University Mainz, Mainz, Germany
| | | | - Helmut Scheu
- Lehr- und Versuchstieranstalt Hofgut Neumühle, Neumühle, Germany
| | - Jürgen Bergeler
- Medical Center of the Johannes Gutenberg, University Mainz, Mainz, Germany.,Free University Berlin, Berlin, Germany
| |
Collapse
|
5
|
Castro Conde JR, González Barrios D, González Campo C, González González NL, Reyes Millán B, Sosa AJ. Visual and Quantitative Electroencephalographic Analysis in Healthy Term Neonates Within the First Six Hours and the Third Day of Life. Pediatr Neurol 2017; 77:54-60.e1. [PMID: 29054698 DOI: 10.1016/j.pediatrneurol.2017.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 04/22/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND What constitutes a "normal" background electroencephalography (EEG) rhythm immediately after birth is not well understood. We performed video-electroencephalography recordings in the first six hours (first measure) and the third day of life (second measure) for evidence of transient changes in brain function. METHODS We performed a cohort study of an incidental sample of healthy term neonates in a single-center nursery. Main outcome measures were as follows: (1) EEG visual analysis, which included sleep-wake cycles, proportions of discontinuity and bursts with delta brushes, and number per hour of alpha/theta rolandic activity, encoches frontales, and transients; and (2) the electroencephalographic spectral analysis, which included power spectrum in the following frequency bands: delta, 0.5 to 4 Hz; theta, 4 to 8 Hz; alpha, 8 to 13 Hz; and beta, 13 to 30 Hz. Theta/delta and alpha/delta ratios were also calculated. RESULTS Twenty-two babies were enrolled. Significant findings (P < 0.05) in the first six hours with respect to 48 to 72 hours of life were (1) increased discontinuity, indeterminate sleep, and bursts with delta brushes; (2) higher number of transients, and lower number of alpha/theta rolandic activity and encoches frontales. Minimal changes were found in power spectrum data. However, using receiver operating characteristic curve analysis, theta/delta ratio ≤0.484 was the best cutoff to discriminate between the two measures (positive predictive value, 100.0; 95% confidence interval 71.0 to 100). CONCLUSIONS In healthy term neonates, immature electroencephalographic patterns, lack of clearly defined sleep-wake cycles, and frequent transients can be considered normal electroencephalographic findings in the first six hours of life. Normative power spectrum data are provided. These findings suggest that neonatal adaptation immediately after birth leads to transient changes in brain function.
Collapse
Affiliation(s)
- José R Castro Conde
- Department of Neonatology, Hospital Universitario de Canarias, La Laguna, Spain.
| | - Desiré González Barrios
- Pediatric Neurology Unit, Department of Pediatrics, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | | | | | - Beatriz Reyes Millán
- Department of Neonatology, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | | |
Collapse
|
6
|
Hartley C, Berthouze L, Mathieson SR, Boylan GB, Rennie JM, Marlow N, Farmer SF. Long-range temporal correlations in the EEG bursts of human preterm babies. PLoS One 2012; 7:e31543. [PMID: 22363669 PMCID: PMC3283672 DOI: 10.1371/journal.pone.0031543] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 01/11/2012] [Indexed: 02/07/2023] Open
Abstract
The electrical activity in the very early human preterm brain, as recorded by scalp EEG, is mostly discontinuous and has bursts of high-frequency oscillatory activity nested within slow-wave depolarisations of high amplitude. The temporal organisation of the occurrence of these EEG bursts has not been previously investigated. We analysed the distribution of the EEG bursts in 11 very preterm (23-30 weeks gestational age) human babies through two estimates of the Hurst exponent. We found long-range temporal correlations (LRTCs) in the occurrence of these EEG bursts demonstrating that even in the very immature human brain, when the cerebral cortical structure is far from fully developed, there is non-trivial temporal structuring of electrical activity.
Collapse
Affiliation(s)
- Caroline Hartley
- Centre for Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, London, United Kingdom
- University College London Institute of Child Health, London, United Kingdom
| | - Luc Berthouze
- University College London Institute of Child Health, London, United Kingdom
- Centre for Computational Neuroscience and Robotics, University of Sussex, Brighton, United Kingdom
| | - Sean R. Mathieson
- Elizabeth Garrett Anderson University College London Institute for Women's Health, London, United Kingdom
| | - Geraldine B. Boylan
- Neonatal Brain Research Group, Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Janet M. Rennie
- Elizabeth Garrett Anderson University College London Institute for Women's Health, London, United Kingdom
| | - Neil Marlow
- Elizabeth Garrett Anderson University College London Institute for Women's Health, London, United Kingdom
| | - Simon F. Farmer
- Institute of Neurology, University College London, London, United Kingdom
| |
Collapse
|
7
|
Fabrizi L, Slater R, Worley A, Meek J, Boyd S, Olhede S, Fitzgerald M. A shift in sensory processing that enables the developing human brain to discriminate touch from pain. Curr Biol 2011; 21:1552-8. [PMID: 21906948 PMCID: PMC3191265 DOI: 10.1016/j.cub.2011.08.010] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 07/08/2011] [Accepted: 08/04/2011] [Indexed: 01/16/2023]
Abstract
When and how infants begin to discriminate noxious from innocuous stimuli is a fundamental question in neuroscience [1]. However, little is known about the development of the necessary cortical somatosensory functional prerequisites in the intact human brain. Recent studies of developing brain networks have emphasized the importance of transient spontaneous and evoked neuronal bursting activity in the formation of functional circuits [2, 3]. These neuronal bursts are present during development and precede the onset of sensory functions [4, 5]. Their disappearance and the emergence of more adult-like activity are therefore thought to signal the maturation of functional brain circuitry [2, 4]. Here we show the changing patterns of neuronal activity that underlie the onset of nociception and touch discrimination in the preterm infant. We have conducted noninvasive electroencephalogram (EEG) recording of the brain neuronal activity in response to time-locked touches and clinically essential noxious lances of the heel in infants aged 28–45 weeks gestation. We show a transition in brain response following tactile and noxious stimulation from nonspecific, evenly dispersed neuronal bursts to modality-specific, localized, evoked potentials. The results suggest that specific neural circuits necessary for discrimination between touch and nociception emerge from 35–37 weeks gestation in the human brain.
Collapse
Affiliation(s)
- Lorenzo Fabrizi
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, UK.
| | | | | | | | | | | | | |
Collapse
|