Ferrari Fabrizio, Bondi Carolina, Lugli Licia, Bedetti Luca, Guidotti Isotta, Banchelli Federico, Lucaccioni Laura, Berardi Alberto
Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, Modena University Hospital, 41125 Modena, Italy.
Post-Graduate School of Paediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, Modena University Hospital, 41125 Modena, Italy.
J Clin Med. 2025 Mar 12;14(6):1920. doi: 10.3390/jcm14061920.
The aim of the study was to evaluate a novel EEG scoring system as a diagnostic and prognostic tool for brain injury in infants who had experienced perinatal asphyxia. The scoring system, based on a semi-quantitative approach, encompassed seven EEG parameters and their aggregate Dammiss score (DS) measured across seven time points (6 h, 12 h, 24 h, 48 h, 72 h, 78 h, and 2 weeks). The EEGs of 61 full-term newborns affected by perinatal asphyxia and treated with therapeutic hypothermia were evaluated. The EEG parameters were correlated with the outcome at 2 years of age: 41 infants showed normal development; 16 presented with mild neurological abnormalities; and 4 developed cerebral palsy. Key EEG features-such as maturational patterns, sleep states, interburst interval, burst morphology and DS at 6 h of life-were highly predictive of outcomes. Correlations were also observed for sleep states, burst morphology, and DS at 12 and 24 h. Notably, burst amplitude and seizure did not correlate with outcome. Additionally, EEG recovery-observed in all patients-was temporarily impaired by seizures in 18% of the cooled infants. The EEG findings within the first 6 h of life were the most predictive of neurodevelopmental outcomes. The DS and EEG maturational features emerged as the most robust indicators of prognosis.
该研究的目的是评估一种新型脑电图评分系统,作为经历围产期窒息的婴儿脑损伤的诊断和预后工具。该评分系统基于半定量方法,涵盖七个脑电图参数及其在七个时间点(6小时、12小时、24小时、48小时、72小时、78小时和2周)测量的综合达米斯评分(DS)。对61名受围产期窒息影响并接受治疗性低温治疗的足月儿的脑电图进行了评估。脑电图参数与2岁时的结局相关:41名婴儿发育正常;16名有轻度神经异常;4名患脑瘫。关键脑电图特征,如成熟模式、睡眠状态、爆发间期、爆发形态以及出生后6小时的DS,对结局具有高度预测性。在12小时和24小时时,睡眠状态、爆发形态和DS也存在相关性。值得注意的是,爆发幅度和癫痫发作与结局无关。此外,所有患者均观察到脑电图恢复,但18%接受低温治疗的婴儿的脑电图恢复因癫痫发作而暂时受损。出生后6小时内的脑电图结果对神经发育结局的预测性最强。DS和脑电图成熟特征是最可靠的预后指标。