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Zhang R, Dong X, Zhang L, Lin X, Wang X, Xu Y, Wu C, Jiang F, Wang J. Quantitative Electroencephalography in Term Neonates During the Early Postnatal Period Across Various Sleep States. Nat Sci Sleep 2024; 16:1011-1025. [PMID: 39071545 PMCID: PMC11282454 DOI: 10.2147/nss.s472595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024] Open
Abstract
Background Neonatal sleep is pivotal for their growth and development, yet manual interpretation of raw images is time-consuming and labor-intensive. Quantitative Electroencephalography (QEEG) presents significant advantages in terms of objectivity and convenience for investigating neonatal sleep patterns. However, research on the sleep patterns of healthy neonates remains scarce. This study aims to identify QEEG markers that distinguish between different neonatal sleep cycles and analyze QEEG alterations across various sleep stages in relation to postmenstrual age. Methods From September 2023 to February 2024, full-term neonates admitted to the neonatology department at the Obstetrics and Gynecology Hospital of Fudan University were enrolled in this study. Electroencephalographic (EEG) recordings were obtained from neonates aged 37-42 weeks, within 1-7 days post-birth. The ROC curve was employed to evaluate QEEG features related to amplitude, range EEG (rEEG), spectral density, and connectivity across different sleep stages. Furthermore, regression analyses were performed to investigate the association between these QEEG characteristics and postmenstrual age. Results The alpha frequency band's spectral_diff_F3 emerged as the most potent discriminator between active sleep (AS) and quiet sleep (QS). In distinguishing AS from wakefulness (W), the theta frequency's spectral_diff_C4 was the most effective, whereas the delta frequency's spectral_diff_P4 excelled in differentiating QS from W. During AS and QS phases, there was a notable increase in entropy within the delta frequency band across all monitored brain regions and in the spectral relative power within the theta frequency band, correlating with postmenstrual age (PMA). Conclusion Spectral difference showcases the highest discriminative capability across awake and various sleep states. The observed patterns of neonatal QEEG alterations in relation to PMA are consistent with the maturation of neonatal sleep, offering insights into the prediction and evaluation of brain development outcomes.
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Affiliation(s)
- Ruijie Zhang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Xinran Dong
- Center for Molecular Medicine, Children’s Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Lu Zhang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Xinao Lin
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Xuefeng Wang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Yan Xu
- Department of Neurology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, People’s Republic of China
| | - Chuyan Wu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Feng Jiang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Jimei Wang
- Department of Neonatology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
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2
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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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3
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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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4
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Luhmann HJ, Kanold PO, Molnár Z, Vanhatalo S. Early brain activity: Translations between bedside and laboratory. Prog Neurobiol 2022; 213:102268. [PMID: 35364141 PMCID: PMC9923767 DOI: 10.1016/j.pneurobio.2022.102268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/01/2022] [Accepted: 03/25/2022] [Indexed: 01/29/2023]
Abstract
Neural activity is both a driver of brain development and a readout of developmental processes. Changes in neuronal activity are therefore both the cause and consequence of neurodevelopmental compromises. Here, we review the assessment of neuronal activities in both preclinical models and clinical situations. We focus on issues that require urgent translational research, the challenges and bottlenecks preventing translation of biomedical research into new clinical diagnostics or treatments, and possibilities to overcome these barriers. The key questions are (i) what can be measured in clinical settings versus animal experiments, (ii) how do measurements relate to particular stages of development, and (iii) how can we balance practical and ethical realities with methodological compromises in measurements and treatments.
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Affiliation(s)
- Heiko J. Luhmann
- Institute of Physiology, University Medical Center of the Johannes Gutenberg University Mainz, Duesbergweg 6, Mainz, Germany.,Correspondence:, , ,
| | - Patrick O. Kanold
- Department of Biomedical Engineering and Kavli Neuroscience Discovery Institute, Johns Hopkins University, School of Medicine, 720 Rutland Avenue / Miller 379, Baltimore, MD 21205, USA.,Correspondence:, , ,
| | - Zoltán Molnár
- Department of Physiology, Anatomy and Genetics, Sherrington Building, University of Oxford, Parks Road, Oxford OX1 3PT, UK.
| | - Sampsa Vanhatalo
- BABA Center, Departments of Physiology and Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
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5
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van 't Westende C, Geraedts VJ, van Ramesdonk T, Dudink J, Schoonmade LJ, van der Knaap MS, Stam CJ, van de Pol LA. Neonatal quantitative electroencephalography and long-term outcomes: a systematic review. Dev Med Child Neurol 2022; 64:413-420. [PMID: 34932822 DOI: 10.1111/dmcn.15133] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/22/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate quantitative electroencephalogram (EEG) measures as predictors of long-term neurodevelopmental outcome in infants with a postconceptional age below 46 weeks, including typically developing infants born at term, infants with heterogeneous underlying pathologies, and infants born preterm. METHOD A comprehensive search was performed using PubMed, Embase, and Web of Science from study inception up to 8th January 2021. Studies that examined associations between neonatal quantitative EEG measures, based on conventional and amplitude-integrated EEG, and standardized neurodevelopmental outcomes at 2 years of age or older were reviewed. Significant associations between neonatal quantitative EEG and long-term outcome measures were grouped into one or more of the following categories: cognitive outcome; motor outcome; composite scores; and other standardized outcome assessments. RESULTS Twenty-four out of 1740 studies were included. Multiple studies showed that conventional EEG-based absolute power in the delta, theta, alpha, and beta frequency bands and conventional and amplitude-integrated EEG-related amplitudes were positively associated with favourable long-term outcome across several domains, including cognition and motor performance. Furthermore, a lower presence of discontinuous background pattern was also associated with favourable outcomes. However, interpretation of the results is limited by heterogeneity in study design and populations. INTERPRETATION Neonatal quantitative EEG measures may be used as prognostic biomarkers to identify those infants who will develop long-term difficulties and who might benefit from early interventions.
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Affiliation(s)
- Charlotte van 't Westende
- Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Victor J Geraedts
- Departments of Neurology and Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tino van Ramesdonk
- Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Marjo S van der Knaap
- Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, the Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Laura A van de Pol
- Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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6
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Alsfouk BA. Neurodevelopmental outcomes in children exposed prenatally to levetiracetam. Ther Adv Drug Saf 2022; 13:20420986221088419. [PMID: 35387387 PMCID: PMC8977694 DOI: 10.1177/20420986221088419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/02/2022] [Indexed: 11/15/2022] Open
Abstract
Some old antiseizure medications (ASMs) pose teratogenic risks, including major
congenital malformations and neurodevelopmental delay. Therefore, the use of new
ASMs in pregnancy is increasing, particularly lamotrigine and levetiracetam.
This is likely due to evidence of low risk of anatomical teratogenicity for both
lamotrigine and levetiracetam. Regarding neurodevelopmental effects, lamotrigine
is the most frequently investigated new ASM with information available for
children up to 14 years of age. However, fewer data are available for the
effects of levetiracetam on cognitive and behavioral development, with smaller
cohorts and shorter follow-up. The aim of the present review was to explicate
neurodevelopmental outcomes in children exposed prenatally to levetiracetam to
support clinical decision-making. The available data do not indicate an
increased risk of abnormal neurodevelopmental outcomes in children exposed
prenatally to levetiracetam. Findings demonstrated comparable outcomes for
levetiracetam versus controls and favorable outcomes for
levetiracetam versus valproate on global and specific cognitive
abilities, and behavioral problems. In addition, the available evidence shows no
significant dose-effect association for levetiracetam on neurodevelopmental
outcomes. However, this evidence cannot be determined definitively due to the
limited numbers of exposures with relatively short follow-up. Therefore, further
research is required.
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Affiliation(s)
- Bshra A. Alsfouk
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah Bint Abdulrahman University, P.O Box 84428, Riyadh 11671, Saudi Arabia
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7
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Tokariev A, Breakspear M, Videman M, Stjerna S, Scholtens LH, van den Heuvel MP, Cocchi L, Vanhatalo S. Impact of In Utero Exposure to Antiepileptic Drugs on Neonatal Brain Function. Cereb Cortex 2021; 32:2385-2397. [PMID: 34585721 PMCID: PMC9157298 DOI: 10.1093/cercor/bhab338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 12/27/2022] Open
Abstract
In utero brain development underpins brain health across the lifespan but is vulnerable to physiological and pharmacological perturbation. Here, we show that antiepileptic medication during pregnancy impacts on cortical activity during neonatal sleep, a potent indicator of newborn brain health. These effects are evident in frequency-specific functional brain networks and carry prognostic information for later neurodevelopment. Notably, such effects differ between different antiepileptic drugs that suggest neurodevelopmental adversity from exposure to antiepileptic drugs and not maternal epilepsy per se. This work provides translatable bedside metrics of brain health that are sensitive to the effects of antiepileptic drugs on postnatal neurodevelopment and carry direct prognostic value.
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Affiliation(s)
- Anton Tokariev
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Michael Breakspear
- School of Psychology, College of Engineering, Science and the Environment, University of Newcastle, Callaghan, New South Wales, Australia.,School of Medicine and Public Health, College of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Mari Videman
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Department of Pediatric Neurology, New Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Susanna Stjerna
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Lianne H Scholtens
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Martijn P van den Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Child Psychiatry, Amsterdam University Medical Center, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Luca Cocchi
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sampsa Vanhatalo
- Baby Brain Activity Center (BABA), Department of Clinical Neurophysiology, New Children's Hospital, HUS Imaging, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
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8
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Pillay K, Dereymaeker A, Jansen K, Naulaers G, De Vos M. Applying a data-driven approach to quantify EEG maturational deviations in preterms with normal and abnormal neurodevelopmental outcomes. Sci Rep 2020; 10:7288. [PMID: 32350387 PMCID: PMC7190650 DOI: 10.1038/s41598-020-64211-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/11/2020] [Indexed: 12/02/2022] Open
Abstract
Premature babies are subjected to environmental stresses that can affect brain maturation and cause abnormal neurodevelopmental outcome later in life. Better understanding this link is crucial to developing a clinical tool for early outcome estimation. We defined maturational trajectories between the Electroencephalography (EEG)-derived ‘brain-age’ and postmenstrual age (the age since the last menstrual cycle of the mother) from longitudinal recordings during the baby’s stay in the Neonatal Intensive Care Unit. Data consisted of 224 recordings (65 patients) separated for normal and abnormal outcome at 9–24 months follow-up. Trajectory deviations were compared between outcome groups using the root mean squared error (RMSE) and maximum trajectory deviation (δmax). 113 features were extracted (per sleep state) to train a data-driven model that estimates brain-age, with the most prominent features identified as potential maturational and outcome-sensitive biomarkers. RMSE and δmax showed significant differences between outcome groups (cluster-based permutation test, p < 0.05). RMSE had a median (IQR) of 0.75 (0.60–1.35) weeks for normal outcome and 1.35 (1.15–1.55) for abnormal outcome, while δmax had a median of 0.90 (0.70–1.70) and 1.90 (1.20–2.90) weeks, respectively. Abnormal outcome trajectories were associated with clinically defined dysmature and disorganised EEG patterns, cementing the link between early maturational trajectories and neurodevelopmental outcome.
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Affiliation(s)
- Kirubin Pillay
- Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, United Kingdom. .,Department of Paediatrics, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
| | - Anneleen Dereymaeker
- Department of Development and Regeneration, University Hospitals Leuven, Neonatal Intensive Care Unit, KU Leuven (University of Leuven), Leuven, Belgium
| | - Katrien Jansen
- Department of Development and Regeneration, University Hospitals Leuven, Neonatal Intensive Care Unit, KU Leuven (University of Leuven), Leuven, Belgium.,Department of Development and Regeneration, University Hospitals Leuven, Child Neurology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Gunnar Naulaers
- Department of Development and Regeneration, University Hospitals Leuven, Neonatal Intensive Care Unit, KU Leuven (University of Leuven), Leuven, Belgium
| | - Maarten De Vos
- Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, United Kingdom
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9
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Marchi V, Stevenson N, Koolen N, Mazziotti R, Moscuzza F, Salvadori S, Pieri R, Ghirri P, Guzzetta A, Vanhatalo S. Measuring Cot-Side the Effects of Parenteral Nutrition on Preterm Cortical Function. Front Hum Neurosci 2020; 14:69. [PMID: 32256325 PMCID: PMC7090162 DOI: 10.3389/fnhum.2020.00069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 02/14/2020] [Indexed: 01/08/2023] Open
Abstract
Early nutritional compromise after preterm birth is shown to affect long-term neurodevelopment, however, there has been a lack of early functional measures of nutritional effects. Recent progress in computational electroencephalography (EEG) analysis has provided means to measure the early maturation of cortical activity. Our study aimed to explore whether computational metrics of early sequential EEG recordings could reflect early nutritional care measured by energy and macronutrient intake in the first week of life. A higher energy or macronutrient intake was assumed to associate with improved development of the cortical activity. We analyzed multichannel EEG recorded at 32 weeks (32.4 ± 0.7) and 36 weeks (36.6 ± 0.9) of postmenstrual age in a cohort of 28 preterm infants born before 32 weeks of postmenstrual age (range: 24.3–32 weeks). We computed several quantitative EEG measures from epochs of quiet sleep (QS): (i) spectral power; (ii) continuity; (iii) interhemispheric synchrony, as well as (iv) the recently developed estimate of maturational age. Parenteral nutritional intake from day 1 to day 7 was monitored and clinical factors collected. Lower calories and carbohydrates were found to correlate with a higher reduction of spectral amplitude in the delta band. Lower protein amount associated with higher discontinuity. Both higher proteins and lipids intake correlated with a more developmental increase in interhemispheric synchrony as well as with better progress in the estimate of EEG maturational age (EMA). Our study shows that early nutritional balance after preterm birth may influence subsequent maturation of brain activity in a way that can be observed with several intuitively reasoned and transparent computational EEG metrics. Such measures could become early functional biomarkers that hold promise for benchmarking in the future development of therapeutic interventions.
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Affiliation(s)
- Viviana Marchi
- Institute of Life Sciences, Scuola Superiore San'Anna, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,BABA Center, Pediatric Research Center, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Nathan Stevenson
- BABA Center, Pediatric Research Center, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.,Department of Clinical Neurophysiology and Neuroscience Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Brain Modelling Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Ninah Koolen
- BABA Center, Pediatric Research Center, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | | | - Francesca Moscuzza
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Stefano Salvadori
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Rossella Pieri
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Paolo Ghirri
- Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care Unit, Santa Chiara Hospital, University of Pisa, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sampsa Vanhatalo
- BABA Center, Pediatric Research Center, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.,Department of Clinical Neurophysiology and Neuroscience Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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10
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Videman M, Stjerna S, Wikström V, Nybo T, Roivainen R, Vanhatalo S, Huotilainen M, Gaily E. Prenatal exposure to antiepileptic drugs and early processing of emotionally relevant sounds. Epilepsy Behav 2019; 100:106503. [PMID: 31525552 DOI: 10.1016/j.yebeh.2019.106503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/10/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Prenatal exposure to antiepileptic drugs (AEDs) is associated with developmental compromises in verbal intelligence and social skills in childhood. Our aim was to evaluate whether a multifeature Mismatch Negativity (MMN) paradigm assessing semantic and emotional components of linguistic and emotional processing would be useful to detect possible alterations in early auditory processing of newborns with prenatal AED exposure. MATERIAL AND METHODS Data on AED exposure, pregnancy outcome, neuropsychological evaluation of the mothers, information on maternal epilepsy type, and a structured neurological examination of the newborn were collected prospectively. Blinded to AED exposure, we compared a cohort of 36 AED-exposed with 46 control newborns at the age of two weeks by measuring MMN with a multifeature paradigm with six linguistically relevant deviant sounds and three emotionally uttered sounds. RESULTS Frontal responses for the emotionally uttered stimulus Happy differed significantly in the exposed newborns compared with the control newborns. In addition, responses to sounds with or without emotional component differed in newborns exposed to multiple AEDs compared with control newborns or to newborns exposed to only one AED. CONCLUSIONS These preliminary findings suggest that prenatal AED exposure may alter early processing of emotionally and linguistically relevant sound information.
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Affiliation(s)
- Mari Videman
- Department of Pediatric Neurology, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Finland.
| | - Susanna Stjerna
- Department of Children's Clinical Neurophysiology, HUS Medical Imaging Center and New Children's Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Valtteri Wikström
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Taina Nybo
- Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Finland
| | - Reina Roivainen
- Clinical Neurosciences, University of Helsinki and Helsinki University Hospital, Finland
| | - Sampsa Vanhatalo
- Department of Children's Clinical Neurophysiology, HUS Medical Imaging Center and New Children's Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Minna Huotilainen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland; CICERO Learning Network, Faculty of Educational Sciences, University of Helsinki, Finland; FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Finland
| | - Eija Gaily
- Department of Pediatric Neurology, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Finland
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Gao W, Grewen K, Knickmeyer RC, Qiu A, Salzwedel A, Lin W, Gilmore JH. A review on neuroimaging studies of genetic and environmental influences on early brain development. Neuroimage 2019; 185:802-812. [PMID: 29673965 PMCID: PMC6191379 DOI: 10.1016/j.neuroimage.2018.04.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 04/11/2018] [Accepted: 04/13/2018] [Indexed: 12/11/2022] Open
Abstract
The past decades witnessed a surge of interest in neuroimaging study of normal and abnormal early brain development. Structural and functional studies of normal early brain development revealed massive structural maturation as well as sequential, coordinated, and hierarchical emergence of functional networks during the infancy period, providing a great foundation for the investigation of abnormal early brain development mechanisms. Indeed, studies of altered brain development associated with either genetic or environmental risks emerged and thrived. In this paper, we will review selected studies of genetic and environmental risks that have been relatively more extensively investigated-familial risks, candidate risk genes, and genome-wide association studies (GWAS) on the genetic side; maternal mood disorders and prenatal drug exposures on the environmental side. Emerging studies on environment-gene interactions will also be reviewed. Our goal was not to perform an exhaustive review of all studies in the field but to leverage some representative ones to summarize the current state, point out potential limitations, and elicit discussions on important future directions.
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Affiliation(s)
- Wei Gao
- Biomedical Imaging Research Institute (BIRI), Department of Biomedical Sciences and Imaging, Cedars-Sinai Medical Center, CA, United States; Department of Medicine, University of California, Los Angeles, CA, United States.
| | - Karen Grewen
- Department of Psychiatry, Neurobiology, and Psychology, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Rebecca C Knickmeyer
- Department of Psychiatry, University of North Carolina at Chapel Hill, N.C, United States
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Andrew Salzwedel
- Biomedical Imaging Research Institute (BIRI), Department of Biomedical Sciences and Imaging, Cedars-Sinai Medical Center, CA, United States
| | - Weili Lin
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, NC, United States
| | - John H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, N.C, United States
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12
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Vrinda M, Arun S, Srikumar B, Kutty BM, Shankaranarayana Rao B. Temporal lobe epilepsy-induced neurodegeneration and cognitive deficits: Implications for aging. J Chem Neuroanat 2019; 95:146-153. [DOI: 10.1016/j.jchemneu.2018.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 12/12/2022]
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13
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Khazipov R, Milh M. Early patterns of activity in the developing cortex: Focus on the sensorimotor system. Semin Cell Dev Biol 2018; 76:120-129. [DOI: 10.1016/j.semcdb.2017.09.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 02/08/2023]
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14
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Videman M, Tokariev A, Saikkonen H, Stjerna S, Heiskala H, Mantere O, Vanhatalo S. Newborn Brain Function Is Affected by Fetal Exposure to Maternal Serotonin Reuptake Inhibitors. Cereb Cortex 2018; 27:3208-3216. [PMID: 27269962 DOI: 10.1093/cercor/bhw153] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Recent experimental animal studies have shown that fetal exposure to serotonin reuptake inhibitors (SRIs) affects brain development. Modern recording methods and advanced computational analyses of scalp electroencephalography (EEG) have opened a possibility to study if comparable changes are also observed in the human neonatal brain. We recruited mothers using SRI during pregnancy (n = 22) and controls (n = 62). Mood and anxiety of mothers, newborn neurology, and newborn cortical function (EEG) were assessed. The EEG parameters were compared between newborns exposed to drugs versus controls, followed by comparisons of newborn EEG features with maternal psychiatric assessments. Neurological assessment showed subtle abnormalities in the SRI-exposed newborns. The computational EEG analyses disclosed a reduced interhemispheric connectivity, lower cross-frequency integration, as well as reduced frontal activity at low-frequency oscillations. These effects were not related to maternal depression or anxiety. Our results suggest that antenatal serotonergic treatment might change newborn brain function in a manner compatible with the recent experimental studies. The present EEG findings suggest links at the level of neuronal activity between human studies and animal experiments. These links will also enable bidirectional translation in future studies on the neuronal mechanisms and long-term neurodevelopmental effects of early SRI exposure.
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Affiliation(s)
- Mari Videman
- Division of Pediatric Neurology, Department of Children and Adolescents.,BABA Center, Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Anton Tokariev
- Department of Children's Clinical Neurophysiology, HUS Medical Imaging Center and Children's Hospital.,Department of Biosciences, University of Helsinki, Helsinki, Finland
| | - Heini Saikkonen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Susanna Stjerna
- Department of Children's Clinical Neurophysiology, HUS Medical Imaging Center and Children's Hospital
| | - Hannu Heiskala
- Division of Pediatric Neurology, Department of Children and Adolescents
| | - Outi Mantere
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, McGill University, Montréal, Canada.,Bipolar Disorders Clinic, Douglas Mental Health University Institute, Montréal, Canada
| | - Sampsa Vanhatalo
- Department of Children's Clinical Neurophysiology, HUS Medical Imaging Center and Children's Hospital
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15
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Léveillé- P, Hamel M, Ardilouze JL, Pasquier JC, Deacon C, Whittingstall K, Plourde M. Pilot study of EEG in neonates born to mothers with gestational diabetes mellitus. Int J Dev Neurosci 2018; 66:37-44. [PMID: 29360555 DOI: 10.1016/j.ijdevneu.2018.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The goal was to evaluate whether there was neurodevelopmental deficits in newborns born to mothers with gestational diabetes mellitus (GDM) compared to control newborns born to healthy mothers. METHODS Forty-six pregnant women (21 controls and 25 GDM) were recruited. Electroencephalogram (EEG) was recorded in the newborns within 48 h after birth. The EEG signal was quantitatively analyzed using power spectral density (PSD); coherence between hemispheres was calculated in paired channels of frontal, temporal, central and occipital regions. RESULTS The left centro-occipital PSD in control newborns was 12% higher than in GDM newborns (p = 0.036) but was not significant after adjustment for gestational age. While coherence was higher in the frontal regions compared to the occipital regions (p < 0.001), there was no difference between the groups for the fronto-temporal, frontal-central, centro-occipital and tempo-occipital regions. CONCLUSION Our results support that EEG differences between groups were mainly modified by gestational age and less by GDM status of the mothers. However, there is a need to confirm this result with a higher number of mother-newborns. Quantitative EEG in GDM newborns within 48 h after birth is feasible. This study emphasizes the importance of controlling blood glucose during GDM to protect infant brain development.
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Affiliation(s)
- Pauline Léveillé-
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada; Department of Physiology, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Institute of Nutrition and Functional Foods, Laval University, Quebec, QC, Canada
| | - Mathieu Hamel
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada
| | - Jean-Luc Ardilouze
- Department of Physiology, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Jean-Charles Pasquier
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Charles Deacon
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada
| | - Kevin Whittingstall
- Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada; Centre de recherche du CHUS, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
| | - Mélanie Plourde
- Research Center on Aging, Centre intégré de santé et services sociaux de l'Estrie-Centre hospitalier de l'Université de Sherbrooke, 1036 Belvédère Sud, Sherbrooke, Quebec, J1H 4C4, Canada; Institute of Nutrition and Functional Foods, Laval University, Quebec, QC, Canada; Department of Medicine, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
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Salman L, Shmueli A, Ashwal E, Hiersch L, Hadar E, Yogev Y, Aviram A. The impact of maternal epilepsy on perinatal outcome in singleton gestations. J Matern Fetal Neonatal Med 2017; 31:3283-3286. [DOI: 10.1080/14767058.2017.1368483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lina Salman
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
| | - Anat Shmueli
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
| | - Eran Ashwal
- Lis Maternity and Women’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liran Hiersch
- Lis Maternity and Women’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel
| | - Yariv Yogev
- Lis Maternity and Women’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amir Aviram
- Lis Maternity and Women’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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17
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Luhmann HJ, Khazipov R. Neuronal activity patterns in the developing barrel cortex. Neuroscience 2017; 368:256-267. [PMID: 28528963 DOI: 10.1016/j.neuroscience.2017.05.025] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/12/2017] [Accepted: 05/12/2017] [Indexed: 11/26/2022]
Abstract
The developing barrel cortex reveals a rich repertoire of neuronal activity patterns, which have been also found in other sensory neocortical areas and in other species including the somatosensory cortex of preterm human infants. The earliest stage is characterized by asynchronous, sparse single-cell firing at low frequencies. During the second stage neurons show correlated firing, which is initially mediated by electrical synapses and subsequently transforms into network bursts depending on chemical synapses. Activity patterns during this second stage are synchronous plateau assemblies, delta waves, spindle bursts and early gamma oscillations (EGOs). In newborn rodents spindle bursts and EGOs occur spontaneously or can be elicited by sensory stimulation and synchronize the activity in a barrel-related columnar network with topographic organization at the day of birth. Interfering with this early activity causes a disturbance in the development of the cortical architecture, indicating that spindle bursts and EGOs influence the formation of cortical columns. Early neuronal activity also controls the rate of programed cell death in the developing barrel cortex, suggesting that spindle bursts and EGOs are physiological activity patterns particularly suited to suppress apoptosis. It remains to be studied in more detail how these different neocortical activity patterns control early developmental processes such as formation of synapses, microcircuits, topographic maps and large-scale networks.
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Affiliation(s)
- Heiko J Luhmann
- Institute of Physiology, University Medical Center of the Johannes Gutenberg University Mainz, Duesbergweg 6, D-55128 Mainz, Germany.
| | - Rustem Khazipov
- INMED - INSERM, Aix-Marseille University, Marseille 13273, France; Laboratory of Neurobiology, Kazan Federal University, Kazan 420008, Russia
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18
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Allegaert K, Simons SHP, Tibboel D, Krekels EH, Knibbe CA, van den Anker JN. Non-maturational covariates for dynamic systems pharmacology models in neonates, infants, and children: Filling the gaps beyond developmental pharmacology. Eur J Pharm Sci 2017; 109S:S27-S31. [PMID: 28506866 DOI: 10.1016/j.ejps.2017.05.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 02/07/2023]
Abstract
Pharmacokinetics and -dynamics show important changes throughout childhood. Studies on the different maturational processes that influence developmental pharmacology have been used to create population PK/PD models that can yield individualized pediatric drug dosages. These models were subsequently translated to semi-physiologically or physiology-based PK (PBPK) models that support predictions in pediatric patient cohorts and other special populations. Although these translational efforts are crucial, these models should be further improved towards individual patient predictions by including knowledge on non-maturational covariates. These efforts are needed to ultimately get to systems pharmacology models for children. These models take developmental changes relating to the pediatric dynamical system into account but also other aspects that may be of importance such as abnormal body composition, pharmacogenetics, critical illness and inflammatory status.
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Affiliation(s)
- Karel Allegaert
- Intensive Care and Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Development and Regeneration KU Leuven, Leuven, Belgium
| | - Sinno H P Simons
- Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
| | - Dick Tibboel
- Intensive Care and Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Elke H Krekels
- Division of Pharmacology, Leiden Academic Center for Drug Research, Leiden, the Netherlands
| | - Catherijne A Knibbe
- Division of Pharmacology, Leiden Academic Center for Drug Research, Leiden, the Netherlands; Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - John N van den Anker
- Intensive Care and Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Division of Clinical Pharmacology, Children's National Health System, Washington, DC, USA; Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel, Switzerland
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19
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Evidence for spared attention to faces in 7-month-old infants after prenatal exposure to antiepileptic drugs. Epilepsy Behav 2016; 64:62-68. [PMID: 27732918 DOI: 10.1016/j.yebeh.2016.09.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/16/2016] [Accepted: 09/11/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Prenatal antiepileptic drug (AED) exposure is associated with an increased risk of cognitive impairment and autism spectrum disorders detected mainly at the age of two to six years. We examined whether the developmental aberrations associated with prenatal AED exposure could be detected already in infancy and whether effects on visual attention can be observed at this early age. MATERIAL AND METHODS We compared a prospective cohort of infants with in utero exposure to AED (n=56) with infants without drug exposures (n=62). The assessments performed at the age of seven months included standardized neurodevelopmental scores (Griffiths Mental Developmental Scale and Hammersmith Infant Neurological Examination) as well as a novel eye-tracking-based test for visual attention and orienting to faces. Background information included prospective collection of AED exposure data, pregnancy outcome, neuropsychological evaluation of the mothers, and information on maternal epilepsy type. RESULTS Carbamazepine, oxcarbazepine, and valproate, but not lamotrigine or levetiracetam, were associated with impaired early language abilities at the age of seven months. The general speed of visuospatial orienting or attentional bias for faces measured by eye-tracker-based tests did not differ between AED-exposed and control infants. DISCUSSION Our findings support the idea that prenatal AED exposure may impair verbal abilities, and this effect may be detected already in infancy. In contrast, the early development of attention to faces was spared after in utero AED exposure.
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20
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Malkki H. Neurodevelopmental disorders: Fetal exposure to antiepileptic drugs could affect brain activity in newborns. Nat Rev Neurol 2016; 12:64. [PMID: 26782332 DOI: 10.1038/nrneurol.2016.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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