宏观周期波动：新生儿脑病结局的潜在新型生物标志物。
Macroperiodic Oscillations: A Potential Novel Biomarker of Outcome in Neonatal Encephalopathy.
机构信息
Division of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, U.S.A.
Department of Electrical and Systems Engineering, Washington University in St. Louis, St. Louis, Missouri, U.S.A.
出版信息
J Clin Neurophysiol. 2024 May 1;41(4):344-350. doi: 10.1097/WNP.0000000000001011. Epub 2023 Apr 12.
PURPOSE
Neonatal encephalopathy (NE) is a common cause of neurodevelopmental morbidity. Tools to accurately predict outcomes after therapeutic hypothermia remain limited. We evaluated a novel EEG biomarker, macroperiodic oscillations (MOs), to predict neurodevelopmental outcomes.
METHODS
We conducted a secondary analysis of a randomized controlled trial of neonates with moderate-to-severe NE who underwent standardized clinical examination, magnetic resonance (MR) scoring, video EEG, and neurodevelopmental assessment with Bayley III evaluation at 18 to 24 months. A non-NE cohort of neonates was also assessed for the presence of MOs. The relationship between clinical examination, MR score, MOs, and neurodevelopmental assessment was analyzed.
RESULTS
The study included 37 neonates with 24 of whom survived and underwent neurodevelopmental assessment (70%). The strength of MOs correlated with severity of clinical encephalopathy. MO strength and spread significantly correlated with Bayley III cognitive percentile ( P = 0.017 and 0.046). MO strength outperformed MR score in predicting a combined adverse outcome of death or disability ( P = 0.019, sensitivity 100%, specificity 77% vs. P = 0.079, sensitivity 100%, specificity 59%).
CONCLUSIONS
MOs are an EEG-derived, quantitative biomarker of neurodevelopmental outcome that outperformed a comprehensive validated MRI injury score and a detailed systematic discharge examination in this small cohort. Future work is needed to validate MOs in a larger cohort and elucidate the underlying pathophysiology of MOs.
目的
新生儿脑病（NE）是神经发育障碍的常见原因。用于准确预测治疗性低温后结局的工具仍然有限。我们评估了一种新的脑电图生物标志物——宏观周期振荡（MOs），以预测神经发育结局。
方法
我们对接受标准临床检查、磁共振（MR）评分、视频脑电图和 18 至 24 个月时的贝利 III 评估的中重度 NE 新生儿进行了一项随机对照试验的二次分析。还评估了一组非 NE 新生儿是否存在 MOs。分析了临床检查、MR 评分、MOs 和神经发育评估之间的关系。
结果
该研究纳入了 37 名新生儿，其中 24 名存活并接受了神经发育评估（70%）。MOs 的强度与临床脑病的严重程度相关。MOs 的强度和扩散与贝利 III 认知百分位显著相关（P = 0.017 和 0.046）。MOs 强度在预测死亡或残疾的复合不良结局方面优于 MR 评分（P = 0.019，敏感性 100%，特异性 77% vs. P = 0.079，敏感性 100%，特异性 59%）。
结论
MOs 是一种 EEG 衍生的、定量的神经发育结局生物标志物，在该小队列中优于全面验证的 MRI 损伤评分和详细的系统出院检查。需要进一步的研究来在更大的队列中验证 MOs，并阐明 MOs 的潜在病理生理学。
Zotero 插件