Amplitude-integrated EEG recorded at 32 weeks postconceptional age correlated with MRI at term

Abstract

Introduction: Preterm birth significantly increases the risk of neurodevelopmental disorders due to the brain's vulnerability during critical gestational weeks. Early detection of brain injuries is essential to facilitate interventions that improve long-term outcomes. While cranial ultrasound (CUS) is commonly used, it may miss subtle brain injuries, whereas MRI provides more detailed structural insights. Amplitude-integrated EEG (aEEG) complements MRI by offering real-time, functional monitoring in the NICU, enhancing neurocritical care and enabling a more comprehensive approach to protecting neonatal brain health.

Objective: This study aims to determine the predictive value of aEEG recorded at 32 weeks postconceptional age and its correlation with MRI findings at term-equivalent age, evaluating aEEG's potential in predicting neurodevelopmental outcomes for preterm neonates.

Methods: A prospective observational study was conducted at Rajarajeswari Medical College and Hospital, Bengaluru, from August 2022 to April 2024. Forty-five preterm neonates born before 32 weeks were assessed with aEEG, and MRI was performed at term-equivalent age. Statistical analyses included correlation assessments between aEEG parameters (continuity, cyclicity, amplitude) and MRI findings.

Results: The study demonstrated significant correlations between aEEG parameters and MRI-detected abnormalities in cerebral white matter, grey matter, and cerebellum. Lower aEEG scores correlated with severe brain injuries. Continuity and cyclicity were notably predictive of brain health, with higher continuity scores linked to greater gestational maturity.

Conclusion: This study highlights aEEG as an effective tool for early neurodevelopmental risk assessment in preterm neonates, particularly when used with MRI. Integrating aEEG into NICU protocols offers a more comprehensive assessment of neonatal brain health, allowing for timely interventions that may significantly improve neurodevelopmental outcomes in this vulnerable population.