epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333/epi.par.con.2022.098epilepsia-770Research ArticleORIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИAmplitude-integrated electroencephalography as an additional research method in newborns with seizuresАмплитудно-интегрированная электроэнцефалография как дополнительный метод исследования у новорожденных детей с судорогамиhttps://orcid.org/0000-0002-3861-4134КощавцевА. Г.KoshchavtsevA. G.

Кощавцев Андрей Гелиевич – кандидат медицинских наук, доцент кафедры психиатрии и наркологии, координатор направления «Психическое здоровье младенцев».

ул. Литовская, д. 2, Санкт-Петербург 194100.

Scopus Author ID: 6504425924

РИНЦ SPIN-код: 5449-3953

Andrey G. Koshchavtsev – MD, PhD, Associate Professor, Chair of Psychiatry and Narcology, Coordinator of “Mental health of infants” direction, Saint Petersburg Pediatric Medical University.

2 Litovskaya Str., Saint Petersburg 194100.

Scopus Author ID: 6504425924

RSCI SPIN-code: 5449-3953

mdspb@yandex.ruСанкт-Петербургский педиатрический медицинский университет Министерства здравоохранения Российской ФедерацииРоссияSaint Petersburg Pediatric Medical UniversityRussian Federation202217042022141814Copyright © Koshchavtsev A.G., 20222022Кощавцев А.Г.Koshchavtsev A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/770Objective

Objective: to compare the  methods of electroencephalography (EEG) and  amplitude-integrated electroencephalography (aEEG), related technical features, their clinical application in newborns  at the intensive care unit, as well as a correlation between aEEG and other diagnostic methods (neurological status, neurosonography).

Material and methods

Material and methods. Fifty-two newborns were examined who mainly born at full-term or had an initial degree of prematurity. In 29 infants, seizures were recorded, which were noted 1–5 times. An EEG was performed  within 107.7±32.7 minutes followed by further software aEEG processing.

Results

Results. While analyzing aEEG, significant differences were found among the indices of delta 2 activity denoted as a percentage in premature vs. full-term infants relative to other rhythms. It was shown that prevalence of high-amplitude delta 2 activity throughout entire recording presented as percentage was higher in infants with vs. without seizures.

Conclusion

Conclusion. It was demonstrated that aEEG clarifies and supplements the data obtained with routine EEG, and can be used not only for conducting continuous monitoring of neonatal brain functions, but also as an additional program to a standard EEG study. The method has a great potential for specifying diagnosis and further neonatal neurological support at intensive care units.

Цель

Цель: сравнение методов электроэнцефалографии (ЭЭГ) и амплитудно-интегрированной  электроэнцефалографии (аЭЭГ), их технических особенностей, клинического применения для новорожденных  в отделении интенсивной терапии, а также корреляции  аЭЭГ с другими методами диагностики (неврологический статус, нейросонография).

Материал и методы

Материал и методы. Обследованы 52 новорожденных  ребенка. Дети чаще были доношенными или имели начальную степень  недоношенности.  У 29 младенцев регистрировались судороги,  которые отмечались 1–5 раз. Проводилась ЭЭГ в течение 107,7±32,7 мин с дальнейшей программной аЭЭГ-обработкой.

Результаты

Результаты. При анализе  аЭЭГ найдены достоверные  различия между индексами дельта-2-активности  в процентах у недоношенных младенцев относительно других ритмов по сравнению с доношенными детьми. Показано, что представленность на протяжении всей записи в процентах высокоамплитудной дельта-2-активности выше у новорожденных с судорогами по сравнению с младенцами без них.

Заключение

Заключение. Таким образом,  аЭЭГ уточняет и дополняет  данные, полученные  с помощью  рутинной ЭЭГ, и может  использоваться  не только в качестве метода непрерывного мониторинга функций мозга у новорожденных детей, но и как дополнительная  программа  к стандартному  ЭЭГ-исследованию. Метод имеет большой потенциал для уточнения диагноза и дальнейшей неврологической  поддержки новорожденных  в отделениях интенсивной терапии.

ЭлектроэнцефалографияЭЭГдетская ЭЭГамплитудно-интегрированная электроэнцефалографияаЭЭГноворожденные детинеонатальные судорогианализ показателей аЭЭГElectroencephalographyEEGchildren's EEGamplitude-integrated EEGaEEGnewbornneonatal seizuresaEEG analysisReferencesBlack J.E. How a child builds its brain: some lessons from animal studies of neural plasticity. Prev Med. 1998; 27 (2): 168–71. https://doi.org/10.1006/pmed.1998.0271.Black J.E. How a child builds its brain: some lessons from animal studies of neural plasticity. Prev Med. 1998; 27 (2): 168–71. https://doi.org/10.1006/pmed.1998.0271.Батуев А.С., Кощавцев А.Г., Соболева М.В. Зрительное предпочтение как проявление привязанности у детей первого года жизни. Вопросы психологии. 1996; 4: 34–41.Batuev A.S., Koshchavtsev A.G., Soboleva M.V. Visual preference as a manifestation of attachment in children of the first year of life. Voprosy Psychologii. 1996; 4: 34–41 (in Russ.).Selton D., Andre M., Hascoët J. Normal EEG in very premature infants: reference criteria. Clin Neurophysiol. 2000; 111 (12): 2116–24. https://doi.org/10.1016/s1388-2457(00)00440-5.Selton D., Andre M., Hascoët J. Normal EEG in very premature infants: reference criteria. Clin Neurophysiol. 2000; 111 (12): 2116–24. https://doi.org/10.1016/s1388-2457(00)00440-5.Selton D., André M., Debruille C., et al. EEG at 6 weeks of life in very premature neonates. Clin Neurophysiol. 2010; 121 (6): 818–22. https://doi.org/10.1016/j.clinph.2009.11.006.Selton D., André M., Debruille C., et al. EEG at 6 weeks of life in very premature neonates. Clin Neurophysiol. 2010; 121 (6): 818–22. https://doi.org/10.1016/j.clinph.2009.11.006.Vecchierini M., André M., d'Allest A. Normal EEG of premature infants born between 24 and 30 weeks gestational age: terminology, definitions and maturation aspects. Neurophysiol. Clin. 2007; 37 (5): 311–23. https://doi.org/10.1016/j.neucli.2007.10.008.Vecchierini M., André M., d'Allest A. Normal EEG of premature infants born between 24 and 30 weeks gestational age: terminology, definitions and maturation aspects. Neurophysiol Clin. 2007; 37 (5): 311–23. https://doi.org/10.1016/j.neucli.2007.10.008.Boylan G. Principles of EEG. In: Rennie J., Hagmann C., Robertson N. (Eds). Neonatal cerebral investigation. New York: Cambridge University Press; 2008: 9–21.Boylan G. Principles of EEG. In: Rennie J., Hagmann C., Robertson N. (Eds). Neonatal cerebral investigation. New York: Cambridge University Press; 2008: 9–21.El-Dib M., Chang T., Tsuchida T., Clancy R. Amplitude-integrated electroencephalography in neonates. Pediatr Neurol. 2009; 41 (5): 315–26. https://doi.org/10.1016/j.pediatrneurol.2009.05.002.El-Dib M., Chang T., Tsuchida T., Clancy R. Amplitude-integrated electroencephalography in neonates. Pediatr Neurol. 2009; 41 (5): 315–26. https://doi.org/10.1016/j.pediatrneurol.2009.05.002.Clancy R., Dicker L., Cho S., et al. Agreement between long-term neonatal background classification by conventional and amplitude-integrated EEG. J Clin Neurophysiol. 2011; 28 (1): 1–9. https://doi.org/10.1097/WNP.0b013e3182051105.Clancy R., Dicker L., Cho S., et al. Agreement between long-term neonatal background classification by conventional and amplitude-integrated EEG. J Clin Neurophysiol. 2011; 28 (1): 1–9. https://doi.org/10.1097/WNP.0b013e3182051105.Hellstrom-Westas L., De Vries L., Rosen I. Atlas of amplitude-integrated EEGs in the newborn. 2nd ed. London, UK: Informa Healthcare; 2008: 187.Hellstrom-Westas L., De Vries L., Rosen I. Atlas of amplitude-integrated EEGs in the newborn. 2nd ed. London, UK: Informa Healthcare; 2008: 187.Кощавцев А.Г., Гречаный С.В. Интерпретация электроэнцефалографии у детей раннего возраста. Эпилепсия и пароксизмальные состояния. 2020; 12 (1): 9–25. https://doi.org/10.17749/2077-8333.2020.12.1.9-25.Koshchavtsev A.G., Grechanyi S.V. Interpretation of electroencephalography in infants. Epilepsia i paroksizmalʹnye sostoania / Epilepsy and Paroxysmal Conditions. 2020; 12 (1): 9–25 (in Russ.). https://doi.org/10.17749/2077-8333.2020.12.1.9-25.Foreman S.W., Thorngate L., Burr R.L., Thomas K.A. Electrode challenges in amplitude-integrated EEG: research application of a novel noninvasive measure of brain function in preterm infants. Biol Res Nurs. 2011; 13 (3): 251–9. https://doi.org/10.1177/1099800411403468.Foreman S.W., Thorngate L., Burr R.L., Thomas K.A. Electrode challenges in amplitude-integrated EEG: research application of a novel noninvasive measure of brain function in preterm infants. Biol Res Nurs. 2011; 13 (3): 251–9. https://doi.org/10.1177/1099800411403468.Klebermass K., Kuhle S., Kohlhauser-Vollmuth C., et al. Evaluation of the cerebral function monitor as a tool for neurophysiological surveillance in neonatal intensive care patients. Childs Nerv Syst. 2001; 17 (9): 544–50. https://doi.org/10.1007/s003810100488.Klebermass K., Kuhle S., Kohlhauser-Vollmuth C., et al. Evaluation of the cerebral function monitor as a tool for neurophysiological surveillance in neonatal intensive care patients. Childs Nerv Syst. 2001; 17 (9): 544–50. https://doi.org/10.1007/s003810100488.Kuint J., Turgeman A., Torjman A., Maayan-Metzger A. Characteristics of amplitude-integrated electroencephalogram in premature infants. J Child Neurol. 2007; 22 (3): 277–81. https://doi.org/10.1177/0883073807299860.Kuint J., Turgeman A., Torjman A., Maayan-Metzger A. Characteristics of amplitude-integrated electroencephalogram in premature infants. J Child Neurol. 2007; 22 (3): 277–81. https://doi.org/10.1177/0883073807299860.Burdjalov V.F., Baumgart S., Spitzer A.R. Cerebral function monitoring: a new scoring system for the evaluation of brain maturation in neonates. Pediatrics. 2003; 112 (4): 855–61. https://doi.org/10.1542/peds.112.4.855.Burdjalov V.F., Baumgart S., Spitzer A.R. Cerebral function monitoring: a new scoring system for the evaluation of brain maturation in neonates. Pediatrics. 2003; 112 (4): 855–61. https://doi.org/10.1542/peds.112.4.855.Olischar M., Klebermass K., Kuhle S., et al. Reference values for amplitude-integrated electroencephalographic activity in preterm infants younger than 30 weeks' gestational age. Pediatrics. 2004; 113 (1 Pt. 1): e61–6. https://doi.org/10.1542/peds.113.1.e61.Olischar M., Klebermass K., Kuhle S., et al. Reference values for amplitude-integrated electroencephalographic activity in preterm infants younger than 30 weeks' gestational age. Pediatrics. 2004; 113 (1 Pt. 1): e61–6. https://doi.org/10.1542/peds.113.1.e61.Archbald F., Verma U., Tejani N., Handwerker S. Cerebral function monitor in the neonate. II: Birth asphyxia. Dev Med Child Neurol. 1984; 26 (2): 162–8. https://doi.org/10.1111/j.1469-8749.1984.tb04427.x.Archbald F., Verma U., Tejani N., Handwerker S. Cerebral function monitor in the neonate. II: Birth asphyxia. Dev Med Child Neurol. 1984; 26 (2): 162–8. https://doi.org/10.1111/j.1469-8749.1984.tb04427.x.Bowen J., Paradisis M., Shah D. Decreased aEEG continuity and baseline variability in the first 48 hours of life associated with poor short-term outcome in neonates born before 29 weeks gestation. Pediatr Res. 2010; 67 (5): 538–44. https://doi.org/10.1203/PDR.0b013e3181d4ecda.Bowen J., Paradisis M., Shah D. Decreased aEEG continuity and baseline variability in the first 48 hours of life associated with poor short-term outcome in neonates born before 29 weeks gestation. Pediatr Res. 2010; 67 (5): 538–44. https://doi.org/10.1203/PDR.0b013e3181d4ecda.El-Dib M., Massaro A., Glass P., et al. Early amplitude integrated EEG and outcome of very low birth weight infants. Pediatr Int. 2011; 53 (3): 315–21. https://doi.org/10.1111/j.1442-200X.2010.03270.x.El-Dib M., Massaro A., Glass P., et al. Early amplitude integrated EEG and outcome of very low birth weight infants. Pediatr Int. 2011; 53 (3): 315–21. https://doi.org/10.1111/j.1442-200X.2010.03270.x.Wikström S., Ley D., Hansen-Pupp I., et al. Early amplitude-integrated EEG correlates with cord TNF-alpha and brain injury in very preterm infants. Acta Pеdiatr. 2008; 97 (7): 915–9. https://doi.org/10.1111/j.1651-2227.2008.00787.x.Wikström S., Ley D., Hansen-Pupp I., et al. Early amplitude-integrated EEG correlates with cord TNF-alpha and brain injury in very preterm infants. Acta Pеdiatr. 2008; 97 (7): 915–9. https://doi.org/10.1111/j.1651-2227.2008.00787.x.

The authors declare that there are no conflicts of interest present.