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van 't Westende C, Twilhaar ES, Stam CJ, de Kieviet JF, van Elburg RM, Oosterlaan J, van de Pol LA. The influence of very preterm birth on adolescent EEG connectivity, network organization and long-term outcome. Clin Neurophysiol 2023; 154:49-59. [PMID: 37549613 DOI: 10.1016/j.clinph.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/01/2023] [Accepted: 07/13/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE The aim of this study was to explore differences in functional connectivity and network organization between very preterm born adolescents and term born controls and to investigate if these differences might explain the relation between preterm birth and adverse long-term outcome. METHODS Forty-seven very preterm born adolescents (53% males) and 54 controls (54% males) with matching age, sex and parental educational levels underwent high-density electroencephalography (EEG) at 13 years of age. Long-term outcome was assessed by Intelligence Quotient (IQ), motor, attentional functioning and academic performance. Two minutes of EEG data were analysed within delta, theta, lower alpha, upper alpha and beta frequency bands. Within each frequency band, connectivity was assessed using the Phase Lag Index (PLI) and Amplitude Envelope Correlation, corrected for volume conduction (AEC-c). Brain networks were constructed using the minimum spanning tree method. RESULTS Very preterm born adolescents had stronger beta PLI connectivity and less differentiated network organization. Beta AEC-c and differentiation of AEC-c based networks were negatively associated with long-term outcomes. EEG measures did not mediate the relation between preterm birth and outcomes. CONCLUSIONS This study shows that very preterm born adolescents may have altered functional connectivity and brain network organization in the beta frequency band. Alterations in measures of functional connectivity and network topologies, especially its differentiating characteristics, were associated with neurodevelopmental functioning. SIGNIFICANCE The findings indicate that EEG connectivity and network analysis is a promising tool for investigating underlying mechanisms of impaired functioning.
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Affiliation(s)
- C van 't Westende
- Amsterdam UMC, Department of Child Neurology, Amsterdam, the Netherlands
| | - E S Twilhaar
- Université de Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, F-75004 Paris, France
| | - C J Stam
- Amsterdam UMC, Department of Clinical Neurophysiology, Amsterdam, the Netherlands
| | - J F de Kieviet
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands
| | - R M van Elburg
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Amsterdam UMC, Department of Amsterdam Gastroenterology & Metabolism, Amsterdam, the Netherlands
| | - J Oosterlaan
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands
| | - L A van de Pol
- Amsterdam UMC, Department of Child Neurology, Amsterdam, the Netherlands.
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2
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Mathewson KJ, Beaton EA, Hobbs D, Hall GBC, Schulkin J, Van Lieshout RJ, Saigal S, Schmidt LA. Brain structure and function in the fourth decade of life after extremely low birth weight: An MRI and EEG study. Clin Neurophysiol 2023; 154:85-99. [PMID: 37595482 DOI: 10.1016/j.clinph.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/27/2023] [Accepted: 06/03/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To examine potential long-term effects of extremely low birth weight (ELBW; ≤ 1000 g) on adult brain structure, brain function, and cognitive-behavioral performance. METHODS A subset of survivors from the prospectively-followed McMaster ELBW Cohort (n = 23, MBW = 816 g) and their peers born at normal birth weight (NBW; ≥ 2500 g; n = 14, MBW = 3361 g) provided T1-weighted magnetic resonance imaging (MRI) brain scans, resting electroencephalographic (EEG) recordings, and behavioral responses to a face-processing task in their early thirties. RESULTS Visual discrimination accuracy for human faces, resting EEG alpha power, and long-distance alpha coherence were lower in ELBW survivors than NBW adults, and volumes of white matter hypointensities (WMH) were higher. Across groups, face-processing performance was correlated positively with posterior EEG spectral power and long-distance alpha and theta coherence, and negatively with WMH. The associations between face-processing scores and parietal alpha power and theta coherence were reduced after adjustment for WMH. CONCLUSIONS Electrocortical activity, brain functional connectivity, and higher-order processing ability may be negatively affected by WMH burden, which is greater in adults born extremely preterm. SIGNIFICANCE Decrements in electrocortical activity and behavioral performance in adult ELBW survivors may be partly explained by increased WMH volumes in this vulnerable population.
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Affiliation(s)
- Karen J Mathewson
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada.
| | - Elliott A Beaton
- Department of Psychology, University of New Orleans, New Orleans, LA, USA
| | - Diana Hobbs
- Department of Psychology, University of New Orleans, New Orleans, LA, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoffrey B C Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Jay Schulkin
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA; Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Saroj Saigal
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Louis A Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
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3
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Horowitz-Kraus T, Randell K, Morag I. Neurobiological perspective on the development of executive functions. Acta Paediatr 2023; 112:1860-1864. [PMID: 37338188 DOI: 10.1111/apa.16883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/21/2023]
Abstract
Executive functions are a set of top-down cognitive processes necessary for emotional self-regulation and goal-directed behaviour supporting, among others, academic abilities. Premature infants are at high risk for subsequent cognitive, psychosocial, or behavioural problems even in the absence of medical complications and in spite of normal brain imaging. Given that this is a sensitive period of brain growth and maturation, these factors may place preterm infants at high risk for executive function dysfunction, disrupted long-term development, and lower academic achievements. Therefore, careful attention to interventions at this age is essential for intact executive functions and academic development.
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Affiliation(s)
- Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology and Faculty of Biomedical Engineering, The Technion, Haifa, Israel
- Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Iris Morag
- Department of Pediatrics, Shamir Medical Center affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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van 't Westende C, Steggerda SJ, Jansen L, van den Berg-Huysmans AA, van de Pol LA, Wiggers-de Bruine FT, Stam CJ, Peeters-Scholte CMPCD. Combining advanced MRI and EEG techniques better explains long-term motor outcome after very preterm birth. Pediatr Res 2022; 91:1874-1881. [PMID: 34031571 DOI: 10.1038/s41390-021-01571-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/20/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Preterm born children are at high risk for adverse motor neurodevelopment. The aim of this study was to establish the relationship between motor outcome and advanced magnetic resonance imaging (MRI) and electroencephalography (EEG) measures. METHODS In a prospective cohort study of 64 very preterm born children, the motor outcome was assessed at 9.83 (SD 0.70) years. Volumetric MRI, diffusion tensor imaging (DTI), and EEG were acquired at 10.85 (SD 0.49) years. We investigated associations between motor outcome and brain volumes (white matter, deep gray matter, cerebellum, and ventricles), white matter integrity (fractional anisotropy and mean, axial and radial diffusivity), and brain activity (upper alpha (A2) functional connectivity and relative A2 power). The independence of associations with motor outcome was investigated with a final model. For each technique, the measure with the strongest association was selected to avoid multicollinearity. RESULTS Ventricular volume, radial diffusivity, mean diffusivity, relative A2 power, and A2 functional connectivity were significantly correlated to motor outcome. The final model showed that ventricular volume and relative A2 power were independently associated with motor outcome (B = -9.42 × 10-5, p = 0.027 and B = 28.9, p = 0.007, respectively). CONCLUSIONS This study suggests that a lasting interplay exists between brain structure and function that might underlie motor outcome at school age. IMPACT This is the first study that investigates the relationships between motor outcome and brain volumes, DTI, and brain function in preterm born children at school age. Ventricular volume and relative upper alpha power on EEG have an independent relation with motor outcome in preterm born children at school age. This suggests that there is a lasting interplay between structure and function that underlies adverse motor outcome.
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Affiliation(s)
- Charlotte van 't Westende
- Department of Child Neurology, Amsterdam University Medical Centers, AMC Site, Amsterdam, The Netherlands. .,Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Sylke J Steggerda
- Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lisette Jansen
- Department of Psychology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Laura A van de Pol
- Department of Child Neurology, Amsterdam University Medical Centers, AMC Site, Amsterdam, The Netherlands
| | | | - Cornelis J Stam
- Department of Clinical Neurophysiology, Amsterdam University Medical Centers, VUmc Site, Amsterdam, The Netherlands
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5
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Neuhaus E, Lowry SJ, Santhosh M, Kresse A, Edwards LA, Keller J, Libsack EJ, Kang VY, Naples A, Jack A, Jeste S, McPartland JC, Aylward E, Bernier R, Bookheimer S, Dapretto M, Van Horn JD, Pelphrey K, Webb SJ. Resting state EEG in youth with ASD: age, sex, and relation to phenotype. J Neurodev Disord 2021; 13:33. [PMID: 34517813 PMCID: PMC8439051 DOI: 10.1186/s11689-021-09390-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 08/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Identification of ASD biomarkers is a key priority for understanding etiology, facilitating early diagnosis, monitoring developmental trajectories, and targeting treatment efforts. Efforts have included exploration of resting state encephalography (EEG), which has a variety of relevant neurodevelopmental correlates and can be collected with minimal burden. However, EEG biomarkers may not be equally valid across the autism spectrum, as ASD is strikingly heterogeneous and individual differences may moderate EEG-behavior associations. Biological sex is a particularly important potential moderator, as females with ASD appear to differ from males with ASD in important ways that may influence biomarker accuracy. METHODS We examined effects of biological sex, age, and ASD diagnosis on resting state EEG among a large, sex-balanced sample of youth with (N = 142, 43% female) and without (N = 138, 49% female) ASD collected across four research sites. Absolute power was extracted across five frequency bands and nine brain regions, and effects of sex, age, and diagnosis were analyzed using mixed-effects linear regression models. Exploratory partial correlations were computed to examine EEG-behavior associations in ASD, with emphasis on possible sex differences in associations. RESULTS Decreased EEG power across multiple frequencies was associated with female sex and older age. Youth with ASD displayed decreased alpha power relative to peers without ASD, suggesting increased neural activation during rest. Associations between EEG and behavior varied by sex. Whereas power across various frequencies correlated with social skills, nonverbal IQ, and repetitive behavior for males with ASD, no such associations were observed for females with ASD. CONCLUSIONS Research using EEG as a possible ASD biomarker must consider individual differences among participants, as these features influence baseline EEG measures and moderate associations between EEG and important behavioral outcomes. Failure to consider factors such as biological sex in such research risks defining biomarkers that misrepresent females with ASD, hindering understanding of the neurobiology, development, and intervention response of this important population.
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Affiliation(s)
- Emily Neuhaus
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Sarah J Lowry
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA
| | - Megha Santhosh
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA
| | - Anna Kresse
- Mailman School of Public Health, Columbia University, New York, USA
| | - Laura A Edwards
- School of Medicine, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jack Keller
- Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, USA
| | - Erin J Libsack
- Department of Psychology, Stony Brook University, Stony Brook, USA
| | - Veronica Y Kang
- Department of Special Education, University of Illinois at Chicago, Chicago, USA
| | - Adam Naples
- Yale Child Study Center, Yale University, New Haven, USA
| | - Allison Jack
- Department of Psychology, George Mason University, Fairfax, USA
| | - Shafali Jeste
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, USA
- Intellectual and Developmental Disabilities Research Center, University of California Los Angeles, Los Angeles, USA
| | | | - Elizabeth Aylward
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, USA
| | - Raphael Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Susan Bookheimer
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, USA
- Intellectual and Developmental Disabilities Research Center, University of California Los Angeles, Los Angeles, USA
| | - Mirella Dapretto
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles School of Medicine, Los Angeles, USA
- Intellectual and Developmental Disabilities Research Center, University of California Los Angeles, Los Angeles, USA
| | - John D Van Horn
- Department of Psychology, University of Virginia, Charlottesville, USA
- School of Data Science, University of Virginia, Charlottesville, USA
| | - Kevin Pelphrey
- Department of Psychology, University of Virginia, Charlottesville, USA
- Department of Neurology, Brain Institute and School of Education and Human Development, University of Virginia, Charlottesville, USA
| | - Sara Jane Webb
- Center on Child Health, Behavior and Development, Seattle Children's Research Institute, 1920 Terry Ave, CURE-03, Seattle, WA, 98101, USA.
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA.
- Intellectual and Developmental Disabilities Research Center, University of Washington, Seattle, USA.
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Guo X, Geng Y, Zhang L, Niu S, Xue J. Early Diagnosis of Brain Injury in Premature Infants Based on Amplitude-Integrated EEG Scoring System. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6684818. [PMID: 33791086 PMCID: PMC7984883 DOI: 10.1155/2021/6684818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 02/03/2023]
Abstract
Analyzing and discussing the relationship between brain injury in preterm infants and related risk factors can provide evidence for perinatal prevention and early intervention of brain injury in preterm infants, thereby improving the quality of life of preterm infants. This paper selects term preterm infants diagnosed with preterm infant asphyxia in the NICU of a university's First Affiliated Hospital from January 2018 to February 2019 as the research object. In addition, healthy term infants born at the same time in the obstetric department of this hospital are selected as the control group. Both groups of premature infants were monitored for brain function within 6 hours after birth. The aEEG results range from background activity (continuous normal voltage, discontinuous normal voltage, burst suppression, continuous low voltage, and plateau) and sleep-wake cycle (no sleep-wake cycle, immature, and mature sleep-wake cycle) to epileptic activity (single seizures, recurrent seizures, and status epilepticus), three aspects to judge. Statistical analysis uses SPSS 17.0 software. Amplitude-integrated EEG is a simplified form of continuous EEG recording. The trace of the trace represents the voltage change signal of the entire EEG background activity, which can reflect the EEG amplitude, frequency, burst-inhibition, and other pieces of information. aEEG can reflect the degree of HIE lesions in premature infants and the long-term prognosis. It is easy to operate and effective in diagnosis and can be continuously monitored. It is worthy of clinical popularization. There is a good correlation between the expression of EEG and biomarkers. Combining multiple methods can diagnose HIE earlier and evaluate the prognosis.
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Affiliation(s)
- Xinyuan Guo
- Department of Neonatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, China
| | - Yanfang Geng
- Huantai County Maternal and Child Health Care Hospital of Zibo City, Zibo, Shandong, 256400, China
| | - Lei Zhang
- Zaozhuang Maternal and Children's Hospital, Zaozhuang, Shandong, 277100, China
| | - Shiping Niu
- Zibo Maternity and Child Health Care Hospital, Zibo, Shandong, 256400, China
| | - Jiang Xue
- Department of Neonatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250033, China
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7
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van 't Westende C, Peeters-Scholte CMPCD, Jansen L, van Egmond-van Dam JC, Tannemaat MR, de Bruïne FT, van den Berg-Huysmans AA, Geraedts VJ, Gouw AA, Steggerda SJ, Stam CJ, van de Pol LA. The degree of prematurity affects functional brain activity in preterm born children at school-age: An EEG study. Early Hum Dev 2020; 148:105096. [PMID: 32534406 DOI: 10.1016/j.earlhumdev.2020.105096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
Prematurely born children are at higher risk for long-term adverse motor and cognitive outcomes. The aim of this paper was to compare quantitative measures derived from electroencephalography (EEG) between extremely (EP) and very prematurely (VP) born children at 9-10 years of age. Fifty-five children born <32 weeks' of gestation underwent EEG at 9-10 years of age and were assessed for motor development and cognitive outcome. Relative frequency power and functional connectivity, as measured by the Phase Lag Index (PLI), were calculated for all frequency bands. Per subject, power spectrum and functional connectivity results were averaged over all channels and pairwise PLI values to explore differences in global frequency power and functional connectivity between EP and VP children. Brain networks were constructed for the upper alpha frequency band using the Minimum Spanning Tree method and were compared between EP and VP children. In addition, the relationships between upper alpha quantitative EEG results and cognitive and motor outcomes were investigated. Relative power and functional connectivity were significantly higher in VP than EP children in the upper alpha frequency band, and VP children had more integrated networks. A strong positive correlation was found between relative upper alpha power and motor outcome whilst controlling for gestational age, age during EEG recording, and gender (ρ = 0.493, p = 0.004). These results suggest that 9-10 years after birth, the effects of the degree of prematurity can be observed in terms of alterations in functional brain activity and that motor deficits are associated with decreases in relative upper alpha power.
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Affiliation(s)
- Charlotte van 't Westende
- Department of Child Neurology, Amsterdam University Medical Centers, De Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands; Department of Neonatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | | | - Lisette Jansen
- Department of Psychology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | | | - Martijn R Tannemaat
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Francisca T de Bruïne
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | | | - Victor J Geraedts
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Department of Clinical Neurophysiology, Amsterdam University Medical Centers, De Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands
| | - Alida A Gouw
- Department of Clinical Neurophysiology, Amsterdam University Medical Centers, De Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands
| | - Sylke J Steggerda
- Department of Neonatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology, Amsterdam University Medical Centers, De Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands
| | - Laura A van de Pol
- Department of Child Neurology, Amsterdam University Medical Centers, De Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands.
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