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Syvälahti T, Tuiskula A, Nevalainen P, Metsäranta M, Haataja L, Vanhatalo S, Tokariev A. Networks of cortical activity show graded responses to perinatal asphyxia. Pediatr Res 2024; 96:132-140. [PMID: 38135725 PMCID: PMC11258028 DOI: 10.1038/s41390-023-02978-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Perinatal asphyxia often leads to hypoxic-ischemic encephalopathy (HIE) with a high risk of neurodevelopmental consequences. While moderate and severe HIE link to high morbidity, less is known about brain effects of perinatal asphyxia with no or only mild HIE. Here, we test the hypothesis that cortical activity networks in the newborn infants show a dose-response to asphyxia. METHODS We performed EEG recordings for infants with perinatal asphyxia/HIE of varying severity (n = 52) and controls (n = 53) and examined well-established computational metrics of cortical network activity. RESULTS We found graded alterations in cortical activity networks according to severity of asphyxia/HIE. Furthermore, our findings correlated with early clinical recovery measured by the time to attain full oral feeding. CONCLUSION We show that both local and large-scale correlated cortical activity are affected by increasing severity of HIE after perinatal asphyxia, suggesting that HIE and perinatal asphyxia are better represented as a continuum rather than the currently used discreet categories. These findings imply that automated computational measures of cortical function may be useful in characterizing the dose effects of adversity in the neonatal brain; such metrics hold promise for benchmarking clinical trials via patient stratification or as early outcome measures. IMPACT Perinatal asphyxia causes every fourth neonatal death worldwide and provides a diagnostic and prognostic challenge for the clinician. We report that infants with perinatal asphyxia show specific graded responses in cortical networks according to severity of asphyxia and ensuing hypoxic-ischaemic encephalopathy. Early EEG recording and automated computational measures of brain function have potential to help in clinical evaluation of infants with perinatal asphyxia.
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Affiliation(s)
- Timo Syvälahti
- Department of Clinical Neurophysiology, Children´s Hospital, and Epilepsia Helsinki, full member of ERN EpiCare, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland.
- BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland.
| | - Anna Tuiskula
- BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland
- Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland
| | - Päivi Nevalainen
- Department of Clinical Neurophysiology, Children´s Hospital, and Epilepsia Helsinki, full member of ERN EpiCare, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland
- BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland
| | - Marjo Metsäranta
- BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland
- Department of Pediatrics, Children's Hospital, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland
| | - Leena Haataja
- Department of Pediatric Neurology, Children's Hospital, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland
| | - Sampsa Vanhatalo
- Department of Clinical Neurophysiology, Children´s Hospital, and Epilepsia Helsinki, full member of ERN EpiCare, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland
- BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland
| | - Anton Tokariev
- BABA center, Pediatric Research Center, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland
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Yrjölä P, Vanhatalo S, Tokariev A. Neuronal Coupling Modes Show Differential Development in the Early Cortical Activity Networks of Human Newborns. J Neurosci 2024; 44:e1012232024. [PMID: 38769006 PMCID: PMC11211727 DOI: 10.1523/jneurosci.1012-23.2024] [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: 05/31/2023] [Revised: 03/27/2024] [Accepted: 04/18/2024] [Indexed: 05/22/2024] Open
Abstract
The third trimester is a critical period for the development of functional networks that support the lifelong neurocognitive performance, yet the emergence of neuronal coupling in these networks is poorly understood. Here, we used longitudinal high-density electroencephalographic recordings from preterm infants during the period from 33 to 45 weeks of conceptional age (CA) to characterize early spatiotemporal patterns in the development of local cortical function and the intrinsic coupling modes [ICMs; phase-phase (PPCs), amplitude-amplitude (AACs), and phase-amplitude correlations (PACs)]. Absolute local power showed a robust increase with CA across the full frequency spectrum, while local PACs showed sleep state-specific, biphasic development that peaked a few weeks before normal birth. AACs and distant PACs decreased globally at nearly all frequencies. In contrast, the PPCs showed frequency- and region-selective development, with an increase of coupling strength with CA between frontal, central, and occipital regions at low-delta and alpha frequencies together with a wider-spread decrease at other frequencies. Our findings together present the spectrally and spatially differential development of the distinct ICMs during the neonatal period and provide their developmental templates for future basic and clinical research.
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Affiliation(s)
- Pauliina Yrjölä
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, New Children's Hospital and HUS Diagnostic Center, Helsinki University Hospital, Helsinki 00290, Finland
- Department of Physiology, University of Helsinki, Helsinki 00014, Finland
| | - Sampsa Vanhatalo
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, New Children's Hospital and HUS Diagnostic Center, Helsinki University Hospital, Helsinki 00290, Finland
- Department of Physiology, University of Helsinki, Helsinki 00014, Finland
| | - Anton Tokariev
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, New Children's Hospital and HUS Diagnostic Center, Helsinki University Hospital, Helsinki 00290, Finland
- Department of Physiology, University of Helsinki, Helsinki 00014, Finland
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Desowska A, Coffman S, Kim I, Underwood E, Tao A, Lopez KL, Nelson CA, Hensch TK, Gabard-Durnam L, Cornelissen L, Berde CB. Neurodevelopment of children exposed to prolonged anesthesia in infancy: GABA study interim analysis of resting-state brain networks at 2, 4, and 10-months old. Neuroimage Clin 2024; 42:103614. [PMID: 38754325 PMCID: PMC11126539 DOI: 10.1016/j.nicl.2024.103614] [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: 01/30/2024] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Previous studies have raised concerns regarding neurodevelopmental impacts of early exposures to general anesthesia and surgery. Electroencephalography (EEG) can be used to study ontogeny of brain networks during infancy. As a substudy of an ongoing study, we examined measures of functional connectivity in awake infants with prior early and prolonged anesthetic exposures and in control infants. METHODS EEG functional connectivity was assessed using debiased weighted phase lag index at source and sensor levels and graph theoretical measures for resting state activity in awake infants in the early anesthesia (n = 26 at 10 month visit, median duration of anesthesia = 4 [2, 7 h]) and control (n = 38 at 10 month visit) groups at ages approximately 2, 4 and 10 months. Theta and low alpha frequency bands were of primary interest. Linear mixed models incorporated impact of age and cumulative hours of general anesthesia exposure. RESULTS Models showed no significant impact of cumulative hours of general anesthesia exposure on debiased weighted phase lag index, characteristic path length, clustering coefficient or small-worldness (conditional R2 0.05-0.34). An effect of age was apparent in many of these measures. CONCLUSIONS We could not demonstrate significant impact of general anesthesia in the first months of life on early development of resting state brain networks over the first postnatal year. Future studies will explore these networks as these infants grow older.
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Affiliation(s)
- Adela Desowska
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Siobhan Coffman
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Isabelle Kim
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Ellen Underwood
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Alice Tao
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Kelsie L Lopez
- Center for Cognitive and Brain Health, Northeastern University, Boston, USA
| | - Charles A Nelson
- Laboratories of Cognitive Neurosciences, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Takao K Hensch
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | | | - Laura Cornelissen
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Charles B Berde
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, USA.
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Al‐Sa'd M, Vanhatalo S, Tokariev A. Multiplex dynamic networks in the newborn brain disclose latent links with neurobehavioral phenotypes. Hum Brain Mapp 2024; 45:e26610. [PMID: 38339895 PMCID: PMC10839739 DOI: 10.1002/hbm.26610] [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: 07/21/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
The higher brain functions arise from coordinated neural activity between distinct brain regions, but the spatial, temporal, and spectral complexity of these functional connectivity networks (FCNs) has challenged the identification of correlates with neurobehavioral phenotypes. Characterizing behavioral correlates of early life FCNs is important to understand the activity dependent emergence of neurodevelopmental performance and for improving health outcomes. Here, we develop an analysis pipeline for identifying multiplex dynamic FCNs that combine spectral and spatiotemporal characteristics of the newborn cortical activity. This data-driven approach automatically uncovers latent networks that show robust neurobehavioral correlations and consistent effects by in utero drug exposure. Altogether, the proposed pipeline provides a robust end-to-end solution for an objective assessment and quantitation of neurobehaviorally meaningful network constellations in the highly dynamic cortical functions.
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Affiliation(s)
- Mohammad Al‐Sa'd
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital, HUS imaging, HUS Diagnostic CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Department of PhysiologyUniversity of HelsinkiHelsinkiFinland
- Faculty of Information Technology and Communication SciencesTampere UniversityTampereFinland
| | - Sampsa Vanhatalo
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital, HUS imaging, HUS Diagnostic CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Department of PhysiologyUniversity of HelsinkiHelsinkiFinland
| | - Anton Tokariev
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital, HUS imaging, HUS Diagnostic CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Department of PhysiologyUniversity of HelsinkiHelsinkiFinland
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Ahtola E, Leikos S, Tuiskula A, Haataja L, Smeds E, Piitulainen H, Jousmäki V, Tokariev A, Vanhatalo S. Cortical networks show characteristic recruitment patterns after somatosensory stimulation by pneumatically evoked repetitive hand movements in newborn infants. Cereb Cortex 2022; 33:4699-4713. [PMID: 36368888 PMCID: PMC10110426 DOI: 10.1093/cercor/bhac373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Controlled assessment of functional cortical networks is an unmet need in the clinical research of noncooperative subjects, such as infants. We developed an automated, pneumatic stimulation method to actuate naturalistic movements of an infant’s hand, as well as an analysis pipeline for assessing the elicited electroencephalography (EEG) responses and related cortical networks. Twenty newborn infants with perinatal asphyxia were recruited, including 7 with mild-to-moderate hypoxic–ischemic encephalopathy (HIE). Statistically significant corticokinematic coherence (CKC) was observed between repetitive hand movements and EEG in all infants, peaking near the contralateral sensorimotor cortex. CKC was robust to common sources of recording artifacts and to changes in vigilance state. A wide recruitment of cortical networks was observed with directed phase transfer entropy, also including areas ipsilateral to the stimulation. The extent of such recruited cortical networks was quantified using a novel metric, Spreading Index, which showed a decrease in 4 (57%) of the infants with HIE. CKC measurement is noninvasive and easy to perform, even in noncooperative subjects. The stimulation and analysis pipeline can be fully automated, including the statistical evaluation of the cortical responses. Therefore, the CKC paradigm holds great promise as a scientific and clinical tool for controlled assessment of functional cortical networks.
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Affiliation(s)
- Eero Ahtola
- Helsinki University Hospital and University of Helsinki Department of Clinical Neurophysiology, BABA Center, Pediatric Research Center, Children’s Hospital and HUS Diagnostics, , Helsinki, 00029 HUS , Finland
- Aalto University School of Science Department of Neuroscience and Biomedical Engineering, , Espoo, 00076 AALTO , Finland
| | - Susanna Leikos
- Helsinki University Hospital and University of Helsinki Department of Clinical Neurophysiology, BABA Center, Pediatric Research Center, Children’s Hospital and HUS Diagnostics, , Helsinki, 00029 HUS , Finland
| | - Anna Tuiskula
- Helsinki University Hospital and University of Helsinki Department of Clinical Neurophysiology, BABA Center, Pediatric Research Center, Children’s Hospital and HUS Diagnostics, , Helsinki, 00029 HUS , Finland
- Helsinki University Hospital and University of Helsinki Department of Pediatric Neurology, Children’s Hospital, , Helsinki, 00029 HUS , Finland
| | - Leena Haataja
- Helsinki University Hospital and University of Helsinki Department of Pediatric Neurology, Children’s Hospital, , Helsinki, 00029 HUS , Finland
| | - Eero Smeds
- Helsinki University Hospital and University of Helsinki Children’s Hospital and Pediatric Research Center, , Helsinki, 00029 HUS , Finland
| | - Harri Piitulainen
- Aalto University School of Science Department of Neuroscience and Biomedical Engineering, , Espoo, 00076 AALTO , Finland
- University of Jyväskylä Faculty of Sport and Health Sciences, , Jyväskylä, 40014 , Finland
| | - Veikko Jousmäki
- Aalto University Aalto NeuroImaging, Department of Neuroscience and Biomedical Engineering, , Espoo, 00076 AALTO , Finland
| | - Anton Tokariev
- Helsinki University Hospital and University of Helsinki Department of Clinical Neurophysiology, BABA Center, Pediatric Research Center, Children’s Hospital and HUS Diagnostics, , Helsinki, 00029 HUS , Finland
| | - Sampsa Vanhatalo
- Helsinki University Hospital and University of Helsinki Department of Clinical Neurophysiology, BABA Center, Pediatric Research Center, Children’s Hospital and HUS Diagnostics, , Helsinki, 00029 HUS , Finland
- University of Helsinki Department of Physiology, , Helsinki, 00014 , Finland
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Yrjölä P, Myers MM, Welch MG, Stevenson NJ, Tokariev A, Vanhatalo S. Facilitating early parent-infant emotional connection improves cortical networks in preterm infants. Sci Transl Med 2022; 14:eabq4786. [PMID: 36170448 DOI: 10.1126/scitranslmed.abq4786] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Exposure to environmental adversities during early brain development, such as preterm birth, can affect early brain organization. Here, we studied whether development of cortical activity networks in preterm infants may be improved by a multimodal environmental enrichment via bedside facilitation of mother-infant emotional connection. We examined functional cortico-cortical connectivity at term age using high-density electroencephalography recordings in infants participating in a randomized controlled trial of Family Nurture Intervention (FNI). Our results identify several large-scale, frequency-specific network effects of FNI, most extensively in the alpha frequency in fronto-central cortical regions. The connectivity strength in this network was correlated to later neurocognitive performance, and it was comparable to healthy term-born infants rather than the infants receiving standard care. These findings suggest that preterm neurodevelopmental care can be improved by a biologically driven environmental enrichment, such as early facilitation of direct human connection.
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Affiliation(s)
- Pauliina Yrjölä
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital and HUS Imaging, Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland.,Department of Physiology, University of Helsinki, 00014 University of Helsinki, Helsinki, Finland
| | - Michael M Myers
- Departments of Psychiatry and Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Martha G Welch
- Departments of Psychiatry and Pediatrics, Columbia University Medical Center, New York, NY 10032, USA
| | - Nathan J Stevenson
- Brain Modelling Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
| | - Anton Tokariev
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital and HUS Imaging, Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland.,Department of Physiology, University of Helsinki, 00014 University of Helsinki, Helsinki, Finland
| | - Sampsa Vanhatalo
- BABA Center, Pediatric Research Center, Department of Clinical Neurophysiology, Children's Hospital and HUS Imaging, Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland.,Department of Physiology, University of Helsinki, 00014 University of Helsinki, Helsinki, Finland
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Tokariev A, Oberlander VC, Videman M, Vanhatalo S. Cortical Cross-Frequency Coupling Is Affected by in utero Exposure to Antidepressant Medication. Front Neurosci 2022; 16:803708. [PMID: 35310093 PMCID: PMC8927083 DOI: 10.3389/fnins.2022.803708] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/27/2022] [Indexed: 11/24/2022] Open
Abstract
Up to five percent of human infants are exposed to maternal antidepressant medication by serotonin reuptake inhibitors (SRI) during pregnancy, yet the SRI effects on infants’ early neurodevelopment are not fully understood. Here, we studied how maternal SRI medication affects cortical frequency-specific and cross-frequency interactions estimated, respectively, by phase-phase correlations (PPC) and phase-amplitude coupling (PAC) in electroencephalographic (EEG) recordings. We examined the cortical activity in infants after fetal exposure to SRIs relative to a control group of infants without medical history of any kind. Our findings show that the sleep-related dynamics of PPC networks are selectively affected by in utero SRI exposure, however, those alterations do not correlate to later neurocognitive development as tested by neuropsychological evaluation at two years of age. In turn, phase-amplitude coupling was found to be suppressed in SRI infants across multiple distributed cortical regions and these effects were linked to their neurocognitive outcomes. Our results are compatible with the overall notion that in utero drug exposures may cause subtle, yet measurable changes in the brain structure and function. Our present findings are based on the measures of local and inter-areal neuronal interactions in the cortex which can be readily used across species, as well as between different scales of inspection: from the whole animals to in vitro preparations. Therefore, this work opens a framework to explore the cellular and molecular mechanisms underlying neurodevelopmental SRI effects at all translational levels.
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Affiliation(s)
- Anton Tokariev
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- *Correspondence: Anton Tokariev,
| | - Victoria C. Oberlander
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Mari Videman
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Pediatric Neurology, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sampsa Vanhatalo
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
- Sampsa Vanhatalo,
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