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Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy

View Article: PubMed Central - PubMed

ABSTRACT

Birth asphyxia constitutes a major global public health burden for millions of infants, despite hypothermia therapy. There is a critical need for real time surrogate markers of therapeutic success, to aid in patient selection and/or modification of interventions in neonatal encephalopathy (NE). This is a proof of concept study aiming to quantify neurovascular coupling (NVC) using wavelet analysis of the dynamic coherence between amplitude-integrated electroencephalography (aEEG) and near-infrared spectroscopy in NE. NVC coupling is assessed by a wavelet metric estimation of percent time of coherence between NIRS SctO2 and aEEG for 78 hours after birth. An abnormal outcome was predefined by a Bayley III score <85 by 18–24 m. We observed high coherence, intact NVC, between the oscillations of SctO2 and aEEG in the frequency range of 0.00025–0.001 Hz in the non-encephalopathic newborns. NVC coherence was significantly decreased in encephalopathic newborns who were cooled vs. non-encephalopathic controls (median IQR 3[2–9] vs.36 [33–39]; p < 0.01), and was significantly lower in those with abnormal 24 months outcomes relative to those with normal outcomes (median IQR 2[1–3] vs 28[19–26], p = 0.04). Wavelet coherence analysis of neurovascular coupling in NE may identify infants at risk for abnormal outcomes.

No MeSH data available.


Wavelet-based SctO2-aEEG coherence showing low neurovascular coupling.This infant had white matter injury on MRI. The Bayley III scores at 18 months are: cognitive 71, language 70, and motor 85. (A) An enlarged segment of the real-time SctO2 and aEEG data. (B) Squared wavelet coherence, , where the x-axis represents time, the y-axis represents scale of frequencies. No significant areas of coherence are seen through the range of time and frequencies studied.
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f2: Wavelet-based SctO2-aEEG coherence showing low neurovascular coupling.This infant had white matter injury on MRI. The Bayley III scores at 18 months are: cognitive 71, language 70, and motor 85. (A) An enlarged segment of the real-time SctO2 and aEEG data. (B) Squared wavelet coherence, , where the x-axis represents time, the y-axis represents scale of frequencies. No significant areas of coherence are seen through the range of time and frequencies studied.

Mentions: Significant in-phase coherence (p < 0.05) between SctO2 and aEEG was identified by the wavelet analysis in the two non-cooled references, in the wavelet scale of 16–64 minutes equivalent to a very low-frequency (VLF) range of 0.00025–0.001 Hz. Similar findings were observed in the cooled infants with a normal Bayley outcomes at 18–24 months post hypothermia therapy (Fig. 1). In contrast, wavelet-based SctO2→aEEG coherence showed decreased NVC for cooled infants with abnormal outcomes. Figure 2, highlights a case example of low NVC where the infant subsequently had white matter injury on MRI day 7 of life, and a Bayley III cognitive score of 70 at 18 months of age. Of note, the observed frequency of NVC coherences was outside the range of SWC frequencies summarized in Table 1, and occurred even in the two cases where no SWC was observed, hence the analysis of NVC did not appear to be influenced by the sleep-awake cycles.


Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy
Wavelet-based SctO2-aEEG coherence showing low neurovascular coupling.This infant had white matter injury on MRI. The Bayley III scores at 18 months are: cognitive 71, language 70, and motor 85. (A) An enlarged segment of the real-time SctO2 and aEEG data. (B) Squared wavelet coherence, , where the x-axis represents time, the y-axis represents scale of frequencies. No significant areas of coherence are seen through the range of time and frequencies studied.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5385531&req=5

f2: Wavelet-based SctO2-aEEG coherence showing low neurovascular coupling.This infant had white matter injury on MRI. The Bayley III scores at 18 months are: cognitive 71, language 70, and motor 85. (A) An enlarged segment of the real-time SctO2 and aEEG data. (B) Squared wavelet coherence, , where the x-axis represents time, the y-axis represents scale of frequencies. No significant areas of coherence are seen through the range of time and frequencies studied.
Mentions: Significant in-phase coherence (p < 0.05) between SctO2 and aEEG was identified by the wavelet analysis in the two non-cooled references, in the wavelet scale of 16–64 minutes equivalent to a very low-frequency (VLF) range of 0.00025–0.001 Hz. Similar findings were observed in the cooled infants with a normal Bayley outcomes at 18–24 months post hypothermia therapy (Fig. 1). In contrast, wavelet-based SctO2→aEEG coherence showed decreased NVC for cooled infants with abnormal outcomes. Figure 2, highlights a case example of low NVC where the infant subsequently had white matter injury on MRI day 7 of life, and a Bayley III cognitive score of 70 at 18 months of age. Of note, the observed frequency of NVC coherences was outside the range of SWC frequencies summarized in Table 1, and occurred even in the two cases where no SWC was observed, hence the analysis of NVC did not appear to be influenced by the sleep-awake cycles.

View Article: PubMed Central - PubMed

ABSTRACT

Birth asphyxia constitutes a major global public health burden for millions of infants, despite hypothermia therapy. There is a critical need for real time surrogate markers of therapeutic success, to aid in patient selection and/or modification of interventions in neonatal encephalopathy (NE). This is a proof of concept study aiming to quantify neurovascular coupling (NVC) using wavelet analysis of the dynamic coherence between amplitude-integrated electroencephalography (aEEG) and near-infrared spectroscopy in NE. NVC coupling is assessed by a wavelet metric estimation of percent time of coherence between NIRS SctO2 and aEEG for 78&thinsp;hours after birth. An abnormal outcome was predefined by a Bayley III score &lt;85 by 18&ndash;24&thinsp;m. We observed high coherence, intact NVC, between the oscillations of SctO2 and aEEG in the frequency range of 0.00025&ndash;0.001&thinsp;Hz in the non-encephalopathic newborns. NVC coherence was significantly decreased in encephalopathic newborns who were cooled vs. non-encephalopathic controls (median IQR 3[2&ndash;9] vs.36 [33&ndash;39]; p&thinsp;&lt;&thinsp;0.01), and was significantly lower in those with abnormal 24 months outcomes relative to those with normal outcomes (median IQR 2[1&ndash;3] vs 28[19&ndash;26], p&thinsp;=&thinsp;0.04). Wavelet coherence analysis of neurovascular coupling in NE may identify infants at risk for abnormal outcomes.

No MeSH data available.