Abnormal Interhemispheric Synchrony in Neonatal Hypoxic-Ischemic Encephalopathy: A Retrospective Pilot Study

Neonatology. 2017;112(4):359-364. doi: 10.1159/000478964. Epub 2017 Aug 11.

Abstract

Background: Abnormal interhemispheric synchrony has been described in many clinical compromises in brain function, but its prognostic value in neonatal hypoxic-ischemic encephalopathy (HIE) is unknown.

Objectives: The study aimed at describing the frequency of abnormal interhemispheric synchrony in infants with HIE and to explore its prognostic value. The main outcome was survival without major disabilities.

Methods: We performed a single-center retrospective cohort study and enrolled 40 neonates with HIE who underwent hypothermia.

Results: Abnormal interhemispheric synchrony was observed in 23% of the patients with HIE. Sensitivity and specificity values for predicting survival without major disabilities were 90 and 67% for seizures, 50 and 97% for status epilepticus, 60 and 97% for highly abnormal EEG in the first 48 h, and 80 and 97% for EEG asynchrony, respectively. The prognostic value of asynchrony improved to 100% sensitivity, whereas specificity remained unchanged, when associated with highly abnormal EEG within the first 48 h of life.

Conclusions: Abnormal interhemispheric synchrony was observed in a quarter of the patients with HIE. This pilot study suggests that the prognostic value of asynchrony is excellent, especially when combined with EEG background analysis.

Keywords: Asphyxia; EEG background; Hypoxic-ischemic encephalopathy; Interhemispheric synchrony; Posterior limb of internal capsule.

MeSH terms

  • Age Factors
  • Cerebrum / diagnostic imaging
  • Cerebrum / physiopathology*
  • Child Development
  • Child, Preschool
  • Disability Evaluation
  • Electroencephalography Phase Synchronization*
  • Humans
  • Hypothermia, Induced
  • Hypoxia-Ischemia, Brain / diagnosis*
  • Hypoxia-Ischemia, Brain / diagnostic imaging
  • Hypoxia-Ischemia, Brain / physiopathology
  • Hypoxia-Ischemia, Brain / therapy
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Paris
  • Pilot Projects
  • Predictive Value of Tests
  • Retrospective Studies
  • Status Epilepticus / diagnosis
  • Status Epilepticus / physiopathology
  • Time Factors
  • Treatment Outcome