Smeds Eero, Vanhatalo Sampsa, Piitulainen Harri, Bourguignon Mathieu, Jousmäki Veikko, Hari Riitta
Department of Neuroscience and Biomedical Engineering, Aalto University, PO Box 12200, 00076 Aalto, Espoo, Finland.
Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Clin Neurophysiol. 2017 Apr;128(4):647-655. doi: 10.1016/j.clinph.2017.01.006. Epub 2017 Jan 29.
Somatosensory evoked potentials have high prognostic value in neonatal intensive care, but their recording from infants is challenging. Here, we studied the possibility to elicit cortical responses in newborns by simple passive hand movements.
We examined 13 newborns (postnatal age 1-46days) during clinically indicated 19-channel electroencephalography (EEG) recordings in the neonatal intensive care unit; EEG indications included birth asphyxia and suspected epileptic seizures. The experimenter moved the infant's wrist or fingers at 1 or 2Hz for 5-10min, separately on both sides. We measured movement kinematics with an accelerometer attached to the infant's hand and computed coherence between the EEG and acceleration signals (corticokinematic coherence, CKC).
Statistically significant CKC (amplitude 0.020-0.511) with characteristic scalp topography was observed in all infants at twice the movement frequency. CKC was contralaterally dominant on the central scalp (median laterality index 0.48 for right-hand and -0.63 for left-hand movements).
Passive movements elicit cortical responses that can be readily observed in clinical EEG recordings from newborns in the intensive-care environment.
CKC is a novel, noninvasive marker for the somatosensory system. Its robustness and practical ease make it attractive for bedside assessment of neurologically compromised newborns.
体感诱发电位在新生儿重症监护中具有很高的预后价值,但从婴儿身上记录该电位具有挑战性。在此,我们研究了通过简单的被动手部运动诱发新生儿皮质反应的可能性。
我们在新生儿重症监护病房对13名新生儿(出生后1 - 46天)进行了临床指征的19通道脑电图(EEG)记录;EEG指征包括出生窒息和疑似癫痫发作。实验者以1或2Hz的频率移动婴儿的手腕或手指,每侧分别移动5 - 10分钟。我们使用附着在婴儿手上的加速度计测量运动学,并计算EEG与加速度信号之间的相干性(皮质运动相干性,CKC)。
在所有婴儿中,在运动频率的两倍处观察到具有特征性头皮地形图的统计学显著CKC(幅度0.020 - 0.511)。CKC在头皮中央对侧占主导(右手运动的中位侧向指数为0.48,左手运动为 - 0.63)。
被动运动可诱发皮质反应,在重症监护环境下新生儿的临床EEG记录中很容易观察到。
CKC是体感系统的一种新型非侵入性标志物。其稳健性和实际操作简便性使其对神经功能受损新生儿的床边评估具有吸引力。