Feng Jinqing, Lin Rouyi, Zhang Yani, Ning Shuyao, Du Na, Li Jianbin, Cui Yanqin, Huang Guodong, Wang Huaizhen, Chen Xinxin, Liu Techang, Chen Wenxiong, Ma Li, Li Jia
Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
Pediatr Res. 2025 Feb;97(2):735-743. doi: 10.1038/s41390-024-03401-2. Epub 2024 Jul 12.
We had reported that postoperative EEG background including sleep-wake cycle (SWC) and discharge (seizures, spikes/sharp waves) abnormalities were significantly correlated with adverse early outcomes in children after cardiac surgery. We aimed to analyze the relations between these EEG abnormalities and neurodevelopmental outcomes at about 2 years after cardiac surgery.
We enrolled 121 patients undergoing cardiac surgery at 3.3 months (0.03 ~ 28 months). EEG abnormalities described above during the first postoperative 48 h were evaluated. Griffiths Mental Development Scales-Chinese was used to evaluate the quotients of overall development and 5 subscales of the child's locomotor, language, personal-social, eye-hand coordination and performance skills at 16 ~ 31 months of age.
EEG background abnormalities occurred in 59/121 (48.8%) patients and 33 (55.9%) unrecovered to normal by 48 h. Abnormal SWC occurred in 15 (12.4%) patients and 7 (5.8%) unrecovered to normal by 48 h. EEG seizures occurred in 11 (9.1%) patients with frontal lobe seizures in 4. Spikes/sharp waves occurred in 100 (82.6%). EEG background abnormalities, number of spikes/sharp waves and frontal lobe seizures were significantly associated with neurodevelopmental impairment at about 1 ~ 2 year after surgery (Ps ≤ 0.05).
Most parameters of EEG abnormalities were significantly associated with neurodevelopmental impairment after cardiac surgery.
Neurodevelopmental impairment in children with congenital heart disease remain poorly understood. Previous studies had reported that either EEG seizures or background abnormalities were associated with worse neurodevelopmental outcomes. Our present study showed that all the EEG background and discharge abnormalities including EEG background, seizures and spikes/sharp waves in the early postoperative period were significantly associated with neurodevelopmental impairment at about 1 ~ 2 years after cardiac surgery. Comprehensive evaluation of early postoperative EEG may provide further insights about postoperative brain injury, its relation with neurodevelopmental impairment, and guide to improve clinical management.
我们曾报道，心脏手术后儿童的脑电图背景，包括睡眠-觉醒周期（SWC）和放电（癫痫发作、棘波/尖波）异常与不良早期预后显著相关。我们旨在分析这些脑电图异常与心脏手术后约2年神经发育结局之间的关系。
我们纳入了121例接受心脏手术的患者，年龄为3.3个月（0.03 ~ 28个月）。评估术后48小时内上述脑电图异常情况。使用格里菲斯心理发展量表中文版评估16 ~ 31个月龄儿童的总体发育商以及运动、语言、个人社交、眼手协调和操作技能5个分量表。
121例患者中有59例（48.8%）出现脑电图背景异常，48小时内33例（55.9%）未恢复正常。15例（12.4%）出现SWC异常，48小时内7例（5.8%）未恢复正常。11例（9.1%）出现脑电图癫痫发作，其中4例为额叶癫痫发作。100例（82.6%）出现棘波/尖波。脑电图背景异常、棘波/尖波数量和额叶癫痫发作与术后约1 ~ 2年的神经发育损害显著相关（P值≤0.05）。
心脏手术后，脑电图异常的大多数参数与神经发育损害显著相关。
先天性心脏病患儿的神经发育损害仍了解不足。既往研究报道，脑电图癫痫发作或背景异常均与较差的神经发育结局相关。我们目前的研究表明，术后早期所有脑电图背景和放电异常，包括脑电图背景、癫痫发作和棘波/尖波，均与心脏手术后约1 ~ 2年的神经发育损害显著相关。术后早期脑电图的综合评估可能为术后脑损伤、其与神经发育损害的关系提供进一步见解，并指导改善临床管理。
