Background

Mild hypoxic-ischemic encephalopathy (HIE) constitutes a large unstudied population with considerable debate on how to define and treat due to the dynamic evolution of the clinical signs of encephalopathy. We propose to address this gap with quantitative physiological biomarkers to aid in stratification of the disease severity. The objectives of this prospective cohort study were to measure the electroencephalographic (EEG) power as an objective biomarker of the evolution of the clinical encephalopathy in newborns with mild to severe HIE.

Methods

EEG was collected in infants with HIE using four bipolar electrodes analyzed for the first three hours of the recording. Delta power (DP, 0.5 to 4 Hz) and total power (TP, 0.5 to 20 Hz) were compared between groups with different HIE severity using a univariate ordinal logistic regression model and receiver operating characteristic curves.

Results

A total of 44 term-born infants with mild to severe HIE were identified within six hours of birth. The DP and TP values were significantly higher for the mild group than for the moderate group for all bipolar electrodes. A one-unit increase in DP was associated with significantly lower odds of encephalopathy. DP best distinguished mild from higher encephalopathy grades by area under the curve.

Conclusions

We conclude that DP and TP are sensitive real-time biomarkers for monitoring the dynamic evolution of the encephalopathy severity in the first day of life. The quantitative EEG power may lead to timely recognition of the worsening of the encephalopathy and guide future therapeutic interventions targeting mild HIE.

中文翻译：

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脑电图谱功率：一种用于实时分类缺氧缺血性脑病严重程度的生理生物标志物

背景

由于脑病临床症状的动态演变，轻度缺氧缺血性脑病 (HIE) 构成了大量未经研究的人群，在如何定义和治疗方面存在相当大的争论。我们建议使用定量生理生物标志物来解决这一差距，以帮助对疾病严重程度进行分层。这项前瞻性队列研究的目的是测量脑电图 (EEG) 功率，作为轻度至重度 HIE 新生儿临床脑病演变的客观生物标志物。

方法

使用四个双极电极在记录的前三个小时分析 HIE 婴儿的脑电图。使用单变量序数逻辑回归模型和受试者工作特征曲线比较不同​​ HIE 严重程度组之间的 Delta 功率（DP，0.5 至 4 Hz）和总功率（TP，0.5 至 20 Hz）。

结果

在出生后 6 小时内，共有 44 名患有轻度至重度 HIE 的足月婴儿被确诊。对于所有双极电极，轻度组的 DP 和 TP 值显着高于中度组。DP增加一个单位与脑病几率显着降低有关。DP 通过曲线下面积最能区分轻度和较高级别的脑病。

结论

我们得出结论，DP 和 TP 是敏感的实时生物标志物，用于监测生命第一天脑病严重程度的动态演变。定量 EEG 功率可能会导致及时识别脑病的恶化，并指导未来针对轻度 HIE 的治疗干预。