Department of Neonatology, Wilhelmina Children's Hospital, Utrecht Medical Center, Utrecht, The Netherlands.
Department of Clinical Neurophysiology, BABA Center, Children's Hospital, HUS Diagnostics, Helsinki University Hospital, Helsinki, Finland.
Hum Brain Mapp. 2022 Nov;43(16):4914-4923. doi: 10.1002/hbm.26040. Epub 2022 Aug 11.
The primary aim of this study is to examine whether bursting interhemispheric synchrony (bIHS) in the first week of life of infants born extremely preterm, is associated with microstructural development of the corpus callosum (CC) on term equivalent age magnetic resonance imaging scans. The secondary aim is to address the effects of analgesics such as morphine, on bIHS in extremely preterm infants. A total of 25 extremely preterm infants (gestational age [GA] < 28 weeks) were monitored with the continuous two-channel EEG during the first 72 h and after 1 week from birth. bIHS was analyzed using the activation synchrony index (ASI) algorithm. Microstructural development of the CC was assessed at ~ 30 and ~ 40 weeks of postmenstrual age (PMA) using fractional anisotropy (FA) measurements. Multivariable regression analyses were used to assess the primary and secondary aim. Analyses were adjusted for important clinical confounders: morphine, birth weight z-score, and white matter injury score. Due to the reduced sample size, only the most relevant variables, according to literature, were included. ASI was not significantly associated with FA of the CC at 30 weeks PMA and at 40 weeks PMA (p > .5). ASI was positively associated with the administration of morphine (p < .05). Early cortical synchrony may be affected by morphine and is not associated with the microstructural development of the CC. More studies are needed to evaluate the long-term effects of neonatal morphine treatment to optimize sedation in this high-risk population.
本研究的主要目的是检验极早产儿出生后第一周的半球间爆发同步性（bIHS）是否与胼胝体（CC）在矫正胎龄磁共振成像扫描时的微观结构发育有关。次要目的是探讨吗啡等镇痛剂对极早产儿 bIHS 的影响。总共 25 名极早产儿（胎龄[GA] < 28 周）在出生后第 1 天至第 72 小时内使用双通道连续脑电图进行监测。使用激活同步指数（ASI）算法分析 bIHS。在大约30 周和40 周的矫正月龄（PMA）时，使用各向异性分数（FA）测量评估 CC 的微观结构发育。使用多变量回归分析来评估主要和次要目标。分析调整了重要的临床混杂因素：吗啡、出生体重 z 评分和白质损伤评分。由于样本量减少，仅根据文献纳入了最相关的变量。ASI 与 30 周 PMA 和 40 周 PMA 时 CC 的 FA 无显著相关性（p>.5）。ASI 与吗啡的使用呈正相关（p<.05）。早期皮质同步性可能受吗啡影响，与 CC 的微观结构发育无关。需要更多的研究来评估新生儿吗啡治疗的长期影响，以优化该高危人群的镇静。
