Zhang Qinfen, Hu Yongsu, Dong Xuan, Tu Wenjuan
Department of Neonatology, Affiliated Changzhou Children's Hospital of Nantong University, Changzhou, China.
Appl Neuropsychol Child. 2022 Jul-Sep;11(3):438-443. doi: 10.1080/21622965.2021.1879085. Epub 2021 Feb 22.
The objective of the study is to investigate the predictive value of electroencephalogram (EEG), event-related potential (ERP), and general movements (GMs) quality assessment in the neurodevelopmental outcome of high-risk infants at one year old.
EEG and ERP were performed in high-risk infants at four weeks old, and GMs quality was evaluated once at 4 weeks and once at 12 weeks. The Gesell score was used to assess neurodevelopment outcome at one year old. A comparative analysis of the effects of EEG, GMs, EEG + ERP, and EEG + ERP + GMs was used to predict high-risk neonatal neurodevelopmental outcome.
Of 71 high-risk infants at the age of one year, 3 (4.23%) had cerebral palsy, 14 (19.72%) had psychomotor retardation, and 54 (76.05%) were normal. The sensitivity, specificity, positive predictive value, and negative predictive value of EEG + ERP + GMs method were 90.00%, 95.08%, 75.00%, and 98.31%, respectively, and these indexes were the highest among the four methods (EEG, GMs, EEG + ERP, and EEG + ERP + GMs). The kappa statistic for the reliability of predicting neurodevelopmental outcome of high risk newborns by the EEG + ERP + GMs method was substantial at 0.785, while the other three methods obtained relatively low Kappa values (0.599, 0.586, and 0.712, respectively).
The combination of EEG, ERP, and GMs quality assessment can greatly improve the prediction of neurodevelopmental outcome of high-risk newborns.
本研究旨在探讨脑电图(EEG)、事件相关电位(ERP)和全身运动(GMs)质量评估对高危婴儿1岁时神经发育结局的预测价值。
对高危婴儿在4周龄时进行脑电图和事件相关电位检查,并在4周和12周时各评估一次全身运动质量。采用盖塞尔评分评估1岁时的神经发育结局。通过比较分析脑电图、全身运动、脑电图+事件相关电位以及脑电图+事件相关电位+全身运动对高危新生儿神经发育结局的预测作用。
71例1岁高危婴儿中,3例(4.23%)患有脑瘫,14例(19.72%)有精神运动发育迟缓,54例(76.05%)正常。脑电图+事件相关电位+全身运动方法的灵敏度、特异度、阳性预测值和阴性预测值分别为90.00%、95.08%、75.00%和98.31%,在四种方法(脑电图、全身运动、脑电图+事件相关电位、脑电图+事件相关电位+全身运动)中这些指标最高。脑电图+事件相关电位+全身运动方法预测高危新生儿神经发育结局可靠性的kappa统计量为0.785,具有较高一致性,而其他三种方法的kappa值相对较低(分别为0.599、0.586和0.712)。
脑电图、事件相关电位和全身运动质量评估相结合可显著提高高危新生儿神经发育结局的预测能力。