Automated cot-side tracking of functional brain age in preterm infants
Stevenson, Nathan J; Oberdorfer, Lisa; Tataranno, Maria-Luisa; Breakspear, Michael; Colditz, Paul B; de Vries, Linda S; Benders, Manon J N L; Klebermass-Schrehof, Katrin; Vanhatalo, Sampsa; Roberts, James A
(2020) Annals of Clinical and Translational Neurology, volume 7, issue 6, pp. 891 - 902
(Article)
Abstract
OBJECTIVE: A major challenge in the care of preterm infants is the early identification of compromised neurological development. While several measures are routinely used to track anatomical growth, there is a striking lack of reliable and objective tools for tracking maturation of early brain function; a cornerstone of lifelong neurological
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health. We present a cot-side method for measuring the functional maturity of the newborn brain based on routinely available neurological monitoring with electroencephalography (EEG). METHODS: We used a dataset of 177 EEG recordings from 65 preterm infants to train a multivariable prediction of functional brain age (FBA) from EEG. The FBA was validated on an independent set of 99 EEG recordings from 42 preterm infants. The difference between FBA and postmenstrual age (PMA) was evaluated as a predictor for neurodevelopmental outcome. RESULTS: The FBA correlated strongly with the PMA of an infant, with a median prediction error of less than 1 week. Moreover, individual babies follow well-defined individual trajectories. The accuracy of the FBA applied to the validation set was statistically equivalent to the training set accuracy. In a subgroup of infants with repeated EEG recordings, a persistently negative predicted age difference was associated with poor neurodevelopmental outcome. INTERPRETATION: The FBA enables the tracking of functional neurodevelopment in preterm infants. This establishes proof of principle for growth charts for brain function, a new tool to assist clinical management and identify infants who will benefit most from early intervention.
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Keywords: Clinical Neurology, General Neuroscience, Journal Article
ISSN: 2328-9503
Publisher: John Wiley and Sons Ltd
Note: Funding Information: This work was supported by the National Health and Medical Research Council of Australia (JAR, MB, SV, PBC, APP1144936; MB, APP1118153), the Rebecca L. Cooper Foundation (JAR, PG2018109), Lastentautiensäätiö (SV), the Academy of Finland (SV, 313242, 288220), Fonds zur Förderung der Wissenschaftlichen Forschung (KKS, FWFKLI237) and the European Commission (LdV, MJNLB; LSHM‐CT‐2006‐036534). Publisher Copyright: © 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.
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