Complexity of Brain Signals is Associated with Outcome in Preterm Infants

Overview

Journal J Cereb Blood Flow Metab

Publisher Sage Publications

Specialties Cardiology & Vascular Diseases
Endocrinology
Neurology

Date 2017 Jan 12

PMID 28075691

Citations 10

Authors

Cristine Sortica da Costa

Michal M Placek

Marek Czosnyka

Brenno Cabella

Magdalena Kasprowicz

Topun Austin

Peter Smielewski

Affiliations

Soon will be listed here.

Abstract

A characteristic feature of complex healthy biological systems is the ability to react and adapt to minute changes in the environment. This 'complexity' manifests itself in highly irregular patterns of various physiological measurements. Here, we apply Multiscale Entropy (MSE) analysis to assess the complexity of systemic and cerebral near-infrared spectroscopy (NIRS) signals in a cohort of 61 critically ill preterm infants born at median (range) gestational age of 26 (23-31) weeks, before 24 h of life. We further correlate the complexity of these parameters with brain injury and mortality. Lower complexity index (CoI) of oxygenated haemoglobin (HbO), deoxygenated haemoglobin (Hb) and tissue oxygenation index (TOI) were observed in those infants who developed intraventricular haemorrhage (IVH) compared to those who did not (P = 0.002, P = 0.010 and P = 0.038, respectively). Mean CoI of HbO, Hb and total haemoglobin index (THI) were lower in those infants who died compared to those who survived (P = 0.012, P = 0.004 and P = 0.003, respectively). CoI-HbO was an independent predictor of IVH (P = 0.010). Decreased complexity of brain signals was associated with mortality and brain injury. Measurement of brain signal complexity in preterm infants is feasible and could represent a significant advance in the brain-oriented care.

Citing Articles

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Blood Pressure Complexity Discriminates Pathological Beat-to-Beat Variability as a Marker of Vascular Aging.

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References

Kluckow M, Evans N . Superior vena cava flow in newborn infants: a novel marker of systemic blood flow. Arch Dis Child Fetal Neonatal Ed. 2000; 82(3):F182-7. PMC: 1721083. DOI: 10.1136/fn.82.3.f182. View

Mukerji A, Shah V, Shah P . Periventricular/Intraventricular Hemorrhage and Neurodevelopmental Outcomes: A Meta-analysis. Pediatrics. 2015; 136(6):1132-43. DOI: 10.1542/peds.2015-0944. View

Pincus S . Approximate entropy as a measure of system complexity. Proc Natl Acad Sci U S A. 1991; 88(6):2297-301. PMC: 51218. DOI: 10.1073/pnas.88.6.2297. View

Costa M, Goldberger A, Peng C . Multiscale entropy analysis of complex physiologic time series. Phys Rev Lett. 2002; 89(6):068102. DOI: 10.1103/PhysRevLett.89.068102. View

Parry G, Tucker J, Tarnow-Mordi W . CRIB II: an update of the clinical risk index for babies score. Lancet. 2003; 361(9371):1789-91. DOI: 10.1016/S0140-6736(03)13397-1. View

Angelini L, Maestri R, Marinazzo D, Nitti L, Pellicoro M, Pinna G . Multiscale analysis of short term heart beat interval, arterial blood pressure, and instantaneous lung volume time series. Artif Intell Med. 2007; 41(3):237-50. DOI: 10.1016/j.artmed.2007.07.012. View

Lu W, Chen J, Chang C, Weng W, Lee W, Shieh J . Multiscale Entropy of Electroencephalogram as a Potential Predictor for the Prognosis of Neonatal Seizures. PLoS One. 2015; 10(12):e0144732. PMC: 4676749. DOI: 10.1371/journal.pone.0144732. View

Evans N, Kluckow M . Early determinants of right and left ventricular output in ventilated preterm infants. Arch Dis Child Fetal Neonatal Ed. 1996; 74(2):F88-94. PMC: 2528520. DOI: 10.1136/fn.74.2.f88. View

Moorman J, Delos J, Flower A, Cao H, Kovatchev B, Richman J . Cardiovascular oscillations at the bedside: early diagnosis of neonatal sepsis using heart rate characteristics monitoring. Physiol Meas. 2011; 32(11):1821-32. PMC: 4898648. DOI: 10.1088/0967-3334/32/11/S08. View

10.

Taussky P, ONeal B, Daugherty W, Luke S, Thorpe D, Pooley R . Validation of frontal near-infrared spectroscopy as noninvasive bedside monitoring for regional cerebral blood flow in brain-injured patients. Neurosurg Focus. 2012; 32(2):E2. DOI: 10.3171/2011.12.FOCUS11280. View

11.

Noori S, McCoy M, Anderson M, Ramji F, Seri I . Changes in cardiac function and cerebral blood flow in relation to peri/intraventricular hemorrhage in extremely preterm infants. J Pediatr. 2013; 164(2):264-70.e1-3. DOI: 10.1016/j.jpeds.2013.09.045. View

12.

Hyttel-Sorensen S, Pellicer A, Alderliesten T, Austin T, van Bel F, Benders M . Cerebral near infrared spectroscopy oximetry in extremely preterm infants: phase II randomised clinical trial. BMJ. 2015; 350:g7635. PMC: 4283997. DOI: 10.1136/bmj.g7635. View

13.

Richman J, Moorman J . Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol. 2000; 278(6):H2039-49. DOI: 10.1152/ajpheart.2000.278.6.H2039. View

14.

Costa M, Goldberger A, Peng C . Multiscale entropy analysis of biological signals. Phys Rev E Stat Nonlin Soft Matter Phys. 2005; 71(2 Pt 1):021906. DOI: 10.1103/PhysRevE.71.021906. View

15.

Costeloe K, Hennessy E, Haider S, Stacey F, Marlow N, Draper E . Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). BMJ. 2012; 345:e7976. PMC: 3514472. DOI: 10.1136/bmj.e7976. View

16.

Brady K, Lee J, Kibler K, Smielewski P, Czosnyka M, Easley R . Continuous time-domain analysis of cerebrovascular autoregulation using near-infrared spectroscopy. Stroke. 2007; 38(10):2818-25. PMC: 2377358. DOI: 10.1161/STROKEAHA.107.485706. View

17.

Riordan Jr W, Norris P, Jenkins J, Morris Jr J . Early loss of heart rate complexity predicts mortality regardless of mechanism, anatomic location, or severity of injury in 2178 trauma patients. J Surg Res. 2009; 156(2):283-9. DOI: 10.1016/j.jss.2009.03.086. View

18.

Mitra S, Czosnyka M, Smielewski P, OReilly H, Brady K, Austin T . Heart rate passivity of cerebral tissue oxygenation is associated with predictors of poor outcome in preterm infants. Acta Paediatr. 2014; 103(9):e374-82. DOI: 10.1111/apa.12696. View

19.

Boudes E, Gilbert G, Leppert I, Tan X, Pike G, Saint-Martin C . Measurement of brain perfusion in newborns: pulsed arterial spin labeling (PASL) versus pseudo-continuous arterial spin labeling (pCASL). Neuroimage Clin. 2014; 6:126-33. PMC: 4215516. DOI: 10.1016/j.nicl.2014.08.010. View

20.

Munro M, Walker A, Barfield C . Hypotensive extremely low birth weight infants have reduced cerebral blood flow. Pediatrics. 2004; 114(6):1591-6. DOI: 10.1542/peds.2004-1073. View