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.

References

1. Wintermark P et al. Am J Neuroradiol 2011;32:2023–29