1. Abnormal Interhemispheric Synchrony in Neonatal Hypoxic-Ischemic Encephalopathy: A Retrospective Pilot Study
- Author
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Ziad Assaf, Jean-François Magny, Nathalie Boddaert, Anne Isabelle Vermersch, Elise Leroy-Terquem, Alexandre Lapillonne, and Pauline Dean
- Subjects
Paris ,medicine.medical_specialty ,Time Factors ,Electroencephalography Phase Synchronization ,Encephalopathy ,Pilot Projects ,Status epilepticus ,Electroencephalography ,Hypoxic Ischemic Encephalopathy ,Disability Evaluation ,03 medical and health sciences ,Child Development ,Status Epilepticus ,0302 clinical medicine ,Hypothermia, Induced ,Predictive Value of Tests ,030225 pediatrics ,Internal medicine ,medicine ,Humans ,Cerebrum ,Retrospective Studies ,Asphyxia ,medicine.diagnostic_test ,business.industry ,Age Factors ,Infant, Newborn ,Infant ,Retrospective cohort study ,Hypothermia ,medicine.disease ,Magnetic Resonance Imaging ,Neonatal Hypoxic Ischemic Encephalopathy ,Treatment Outcome ,Child, Preschool ,Anesthesia ,Hypoxia-Ischemia, Brain ,Pediatrics, Perinatology and Child Health ,Cardiology ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Developmental Biology - Abstract
Background: Abnormal interhemispheric synchrony has been described in many clinical compromises in brain function, but its prognostic value in neonatal hypoxic-ischemic encephalopathy (HIE) is unknown. Objectives: The study aimed at describing the frequency of abnormal interhemispheric synchrony in infants with HIE and to explore its prognostic value. The main outcome was survival without major disabilities. Methods: We performed a single-center retrospective cohort study and enrolled 40 neonates with HIE who underwent hypothermia. Results: Abnormal interhemispheric synchrony was observed in 23% of the patients with HIE. Sensitivity and specificity values for predicting survival without major disabilities were 90 and 67% for seizures, 50 and 97% for status epilepticus, 60 and 97% for highly abnormal EEG in the first 48 h, and 80 and 97% for EEG asynchrony, respectively. The prognostic value of asynchrony improved to 100% sensitivity, whereas specificity remained unchanged, when associated with highly abnormal EEG within the first 48 h of life. Conclusions: Abnormal interhemispheric synchrony was observed in a quarter of the patients with HIE. This pilot study suggests that the prognostic value of asynchrony is excellent, especially when combined with EEG background analysis.
- Published
- 2017