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Neuroimage Clin. 2014 Jul 6;5:256-65. doi: 10.1016/j.nicl.2014.06.012. eCollection 2014.

Mapping cortical haemodynamics during neonatal seizures using diffuse optical tomography: a case study.

Author information

1
neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
2
neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
3
Department of Developmental Psychology, University of Padova, Padova, Italy.
4
Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT, UK.
5
neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge CB2 0QQ, UK ; Department of Neurophysiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.

Abstract

Seizures in the newborn brain represent a major challenge to neonatal medicine. Neonatal seizures are poorly classified, under-diagnosed, difficult to treat and are associated with poor neurodevelopmental outcome. Video-EEG is the current gold-standard approach for seizure detection and monitoring. Interpreting neonatal EEG requires expertise and the impact of seizures on the developing brain remains poorly understood. In this case study we present the first ever images of the haemodynamic impact of seizures on the human infant brain, obtained using simultaneous diffuse optical tomography (DOT) and video-EEG with whole-scalp coverage. Seven discrete periods of ictal electrographic activity were observed during a 60 minute recording of an infant with hypoxic-ischaemic encephalopathy. The resulting DOT images show a remarkably consistent, high-amplitude, biphasic pattern of changes in cortical blood volume and oxygenation in response to each electrographic event. While there is spatial variation across the cortex, the dominant haemodynamic response to seizure activity consists of an initial increase in cortical blood volume prior to a large and extended decrease typically lasting several minutes. This case study demonstrates the wealth of physiologically and clinically relevant information that DOT-EEG techniques can yield. The consistency and scale of the haemodynamic responses observed here also suggest that DOT-EEG has the potential to provide improved detection of neonatal seizures.

KEYWORDS:

Diffuse optical tomography (DOT); Functional near infrared spectroscopy (fNIRS); Hypoxic–ischaemic encephalopathy (HIE); Neonatal seizures

PMID:
25161892
PMCID:
PMC4141980
DOI:
10.1016/j.nicl.2014.06.012
[Indexed for MEDLINE]
Free PMC Article

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