Background and aims (a)EEG predicts outcome in full-term infants with HIE. Recently, increased perfusion in the basal ganglia, detected with arterial spin labelling (ASL), was shown to be related to brain injury1. Our aim was to investigate the relationship between (a)EEG and brain tissue perfusion.
Methods 20 subjects with HIE, eligible for hypothermia, were enrolled. Four 1-hour periods were selected from the (a)EEG: P1 (4–6 h), P2 (20–24 h), P3 (32–36 h) and P4 (44–48 h). Burst-rate (number of burst/min) and IBI (interburst interval) from the rawEEG, minimum (MIN) amplitude (µV) and the% of time <5 µV (% < 5 µV) of the aEEG, were included in the analysis. Mean perfusion in the basal ganglia and thalami (BGT-CBF) was measured using ASL-MRI.
Results In P1 a relation was found for suppressed aEEG signal (% <5 µV: p = 0.015; R = 0.709; MIN: p = 0.028; R = -0.659) and increased BGT-CBF. Concomitantly, a negative correlation was found between burst-rate and BGT-CBF, MIN in P2–3–4 (p < 0.05), whereas suppressed background pattern expressed by% <5 µV and IBI correlated positively with higher BGT-CBF (p < 0.05). In the multivariable regression, corrected for sedatives and anti-epileptic medication, the association between EEG parameters and BGT-CBF persisted (p < 0.05), with the exception of burst-rate in P1.
Conclusion A depressed cortical activity in the first 48 h after birth, secondary to hypoxic-ischemia, is related to an abnormally increased brain perfusion. Using both techniques together might be of additional value to predict neurodevelopmental outcome.
Wintermark P et al. Am J Neuroradiol 2011;32:2023–29