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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.


Individual data of significant SctO2→aEEG in-phase coherence from newborns quantified in: (A) normal outcome group (n = 4), and (B) abnormal outcome group (n = 6). The two non-cooled are labeled by + and • in the left panel. Significant differences between normal vs. abnormal groups (p < 0.05) was observed in the frequency range of 0.00025–0.001 Hz, highlighted by gray shade.
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f3: Individual data of significant SctO2→aEEG in-phase coherence from newborns quantified in: (A) normal outcome group (n = 4), and (B) abnormal outcome group (n = 6). The two non-cooled are labeled by + and • in the left panel. Significant differences between normal vs. abnormal groups (p < 0.05) was observed in the frequency range of 0.00025–0.001 Hz, highlighted by gray shade.

Mentions: Figure 3 Describes the percentage of significant coherence plotted for each individual patient with or without abnormal outcomes at 18–24 months. According to this figure, the most distinct differences between infants with normal vs. abnormal outcomes were observed in a very low-frequency (VLF) range of 0.00025–0.001 Hz (wavelet scale s = 16–64 minutes). The boxplot distribution Fig. 4 shows significant differences in NVC coherence between groups. NVC coherence was significantly lower in newborns with abnormal outcomes compared to normal outcomes (median IQR 2[1–3] vs 28[19–26], p = 0.04).


Novel Wavelet Real Time Analysis of Neurovascular Coupling in Neonatal Encephalopathy
Individual data of significant SctO2→aEEG in-phase coherence from newborns quantified in: (A) normal outcome group (n = 4), and (B) abnormal outcome group (n = 6). The two non-cooled are labeled by + and • in the left panel. Significant differences between normal vs. abnormal groups (p < 0.05) was observed in the frequency range of 0.00025–0.001 Hz, highlighted by gray shade.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3: Individual data of significant SctO2→aEEG in-phase coherence from newborns quantified in: (A) normal outcome group (n = 4), and (B) abnormal outcome group (n = 6). The two non-cooled are labeled by + and • in the left panel. Significant differences between normal vs. abnormal groups (p < 0.05) was observed in the frequency range of 0.00025–0.001 Hz, highlighted by gray shade.
Mentions: Figure 3 Describes the percentage of significant coherence plotted for each individual patient with or without abnormal outcomes at 18–24 months. According to this figure, the most distinct differences between infants with normal vs. abnormal outcomes were observed in a very low-frequency (VLF) range of 0.00025–0.001 Hz (wavelet scale s = 16–64 minutes). The boxplot distribution Fig. 4 shows significant differences in NVC coherence between groups. NVC coherence was significantly lower in newborns with abnormal outcomes compared to normal outcomes (median IQR 2[1–3] vs 28[19–26], p = 0.04).

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.