Dereymaeker, A. | Search bioRxiv

bioRxiv2024

Apnoea suppresses brain activity in infants

Apnoea - the cessation of breathing - is commonly observed in premature infants. These events can reduce cerebral oxygenation and are associated with poorer neurodevelopmental outcomes. However, relatively little is known about how apnoea and shorter pauses in breathing impact brain function in infants, which will provide greater mechanistic understanding of how apnoea affects brain development. We analysed simultaneous recordings of respiration, electroencephalography (EEG), heart rate, and peripheral oxygen saturation in 124 recordings from 118 infants (post-menstrual age: 38.6 {+/-} 2.7 weeks [mean {+/-} standard deviation]) during apnoeas (pauses in breathing greater than 15 seconds) and shorter pauses in breathing between 5 and 15 seconds. EEG amplitude significantly decreased during both apnoeas and shorter pauses in breathing compared with normal breathing periods. Change in EEG amplitude was significantly associated with change in heart rate during apnoea and breathing pauses and, during apnoeas only, with oxygen saturation change. No associations were found between EEG amplitude and pause duration or post-menstrual age. The decrease in EEG amplitude may be a result of the changing metabolism and/or homeostasis following changes in oxygen and carbon dioxide concentrations, which alters the release of neurotransmitters. As apnoeas often occur in premature infants, frequent disruption to brain activity may impact neural development and result in long-term neurodevelopmental consequences.

neuroscience↗

bioRxiv2023

Brain age as an estimator of neurodevelopmental outcome: A deep learning approach for neonatal cot-side monitoring

The preterm neonate can experience stressors that affect the rate of brain maturation and lead to long-term neurodevelopmental deficits. However, some neonates who are born early follow normal developmental trajectories. Extraction of data from electroencephalography (EEG) signals can be used to calculate the neonates brain age which can be compared to their true age. Discrepancies between true age and brain age (the brain age delta) can then be used to quantify maturational deviation, which has been shown to correlate with long-term abnormal neurodevelopmental outcomes. Nevertheless, current brain age models that are based on traditional analytical techniques are less suited to clinical cot-side monitoring due to their dependency on long-duration EEG recordings, the need to record activity across multiple EEG channels, and the manual calculation of predefined EEG features which is time-consuming and may not fully capture the wealth of information in the EEG signal. In this study, we propose an alternative deep-learning approach to determine brain age, which operates directly on the EEG, using a Convolutional Neural Network (CNN) block based on the Inception architecture (called Sinc). Using this deep-learning approach on a dataset of preterm infants with normal neurodevelopmental outcomes (where we assume brain age = postmenstrual age), we can calculate infant brain age with a Mean Absolute Error (MAE) of 0.78 weeks (equivalent to a brain age estimation error for the infant within +/- 5.5 days of their true age). Importantly, this level of accuracy can be achieved by recording only 20 minutes of EEG activity from a single channel. This compares favourably to the degree of accuracy that can be achieved using traditional methods that require long duration recordings (typically >2 hours of EEG activity) recorded from a higher density 8-electrode montage (MAE = 0.73 weeks). Importantly, the deep learning models brain age deltas also distinguish between neonates with normal and severely abnormal outcomes (Normal MAE = 0.71 weeks, severely abnormal MAE = 1.27 weeks, p=0.02, one-way ANOVA), making it highly suited for potential clinical applications. Lastly, in an independent dataset collected at an independent site, we demonstrate the models generalisability in age prediction, as accurate age predictions were also observed (MAE of 0.97 weeks). HighlightsO_LIPreterm stress exposure leads to long-term neurodevelopmental deficits C_LIO_LIDeficits are quantifiable using EEG-based brain age prediction errors C_LIO_LIOur deep-learning solution for brain age prediction outperforms previous approaches C_LIO_LIPredictions are achieved with only 20 mins EEG and a single bipolar channel C_LIO_LIPrediction errors correlate with long-term Bayley scale neurodevelopmental outcomes C_LI

neuroscience↗