Despite advances in perinatal care over the past decades, extremely low birth weight (ELBW: birth weight <1000gm;age at birth ~ <30 wks) infants are at high risk for cerebral palsy (CP), developmental delay, and sensory-motor deficits in infancy and learning disabilities, dyslexia, and hyperactivity-inattention syndromes at school age. Risk factors for these poor outcomes include abnormalities on head ultrasound exam (HUS), chronic lung disease (CLD), weight and age at birth, intrauterine growth restriction (IUGR), sepsis, chorioamnionitis, necrotizing enterocolitis, use of postnatal steroids, and sex. The most striking association with CP and adverse mental development is an abnormal HUS with evidence of intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and ventriculomegaly. However, recent clinical research has demonstrated that adverse outcome can occur in ELBW infants with a normal HUS. Magnetic Resonance Imaging (MRI) at term equivalent age shows that ELBW infants have diffuse white matter injury and regionally reduced brain tissue volumes that correlate with adverse neurodevelopmental outcome. These findings point to a gap in our diagnostic techniques for a more readily available and sensitive means to identify, early on, subtle cerebral abnormalities that presage abnormal clinical outcomes later in life. Based on our preliminary research, we propose that measures of electrocortical synchrony derived from analyses of high density (128-lead) EEG from ELBW infants can identify both the location and extent of altered cortical function that is related to perinatal risk factors for adverse neurodevelopmental outcome. Quantitative computations of EEG waveform synchrony at various spatial scales are acknowledged measures of regional neural functional connectivity. At the smallest scales (
| Grieve, Philip G; Isler, Joseph R; Izraelit, Asya et al. (2008) EEG functional connectivity in term age extremely low birth weight infants. Clin Neurophysiol 119:2712-20 |
