Background: Neuromonitoring at the bedside is the key to understand the pathophysiological mechanisms of brain injury associated with neonatal encephalopathy. The current practice is to monitor the forehead using a noninvasive cerebral oximetry-it remains unknown to what extent cerebral hemodynamics in other brain regions is different to the frontal region.
Method: A multichannel near-infrared spectroscopy (NIRS) system was used to monitor neonates (n = 14) with fetal acidosis and mild neonatal encephalopathy at four brain regions (the frontal, posterior, left temporal, and right temporal lobes). The data were compared to delineate the regional difference in (1) cerebral hemodynamics and (2) pressure autoregulation. For both analyses, wavelet transform coherence was applied.
Results: We observed frontal-posterior heterogeneity as indicated by significantly lower coherence between these two regions (p = 0.02). Furthermore, areas with regional magnetic resonance imaging (MRI)-detected lesions showed greater hemodynamic variations compared to non-affected areas (p = 0.03), while cerebral autoregulation was not affected and showed no difference.
Conclusion: Cerebral hemodynamics in mild neonatal encephalopathy is heterogeneous across different brain regions, while cerebral autoregulation remains intact. These findings indicate the robustness of the wavelet measure of cerebral autoregulation in this population, but need to be further investigated in the presence of severe injury.
Impact: This proof-of-concept study is the first to investigate the regional difference of cerebral hemodynamics and autoregulation in mild neonatal encephalopathy. Study findings confirm that brain functions are complex in the developing neonatal brain and that cerebral hemodynamics are region specific in newborns with frontal-posterior heterogeneity among brain regions probed by multichannel NIRS. Regional MRI lesions were associated with differences across NIRS regional channels among the affected side. Cerebral autoregulation with multichannel NIRS is not affected by regional MRI abnormalities.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1038/s41390-020-0992-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Safety and Efficacy of Selexipag for Pediatric Pulmonary Arterial Hypertension in Japanese Patients - An Open-Label Phase 2 Study.
Circ J
January 2025
Department of Echo-imaging Center, Aizawa Hospital.
Background: Selexipag, an oral prostacyclin (PGI) receptor agonist, is approved for adult patients with pulmonary arterial hypertension (PAH). This study evaluated the efficacy and safety of selexipag for Japanese pediatric patients with PAH.
Methods And Results: The study enrolled 6 patients who received selexipag twice daily at an individualized dose based on body weight; maintenance doses were determined for each patient by 12 weeks after starting administration.
Child Neurology: Severe -Related Congenital Muscular Dystrophy With Rapidly Progressive Encephalopathy Leading to Infantile Death.
Neurology
February 2025
Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
Pathogenic variants in cause congenital muscular dystrophy through hypoglycosylation of alpha-dystroglycan (OMIM #615350). The established phenotypic spectrum of GMPPB-related disorders includes recurrent rhabdomyolysis, limb-girdle muscular dystrophy, neuromuscular transmission abnormalities, and congenital muscular dystrophy with variable brain and eye anomalies. We report a 9-month-old male infant with congenital muscular dystrophy, infantile spasms, and compound heterozygous pathogenic variants (c.
View Article and Find Full Text PDFPhysiological fingerprinting of audiovisual warnings in assisted driving conditions: an investigation of fMRI and peripheral physiological indicators.
Brain Struct Funct
January 2025
Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.
Physiological responses derived from audiovisual perception during assisted driving are associated with the regulation of the autonomic nervous system (ANS), especially in emergencies. However, the interaction of event-related brain activity and the ANS regulating peripheral physiological indicators (i.e.
View Article and Find Full Text PDFParallel EEG-fNIRS assessments of covert cognition in behaviorally non-responsive ICU patients: A multi-task feasibility study in a case of acute motor sensory axonal neuropathy.
J Neurol
January 2025
Western Institute of Neuroscience, Western University, London, Canada.
Background: Repeat neurological assessment is standard in cases of severe acute brain injury. However, conventional measures rely on overt behavior. Unfortunately, behavioral responses may be difficult or impossible for some patients.
View Article and Find Full Text PDFDevelopment of a Framework for the Hemodynamic Impact of Positive End-Expiratory Pressure in Normal and Heart Failure Conditions.
Am J Physiol Heart Circ Physiol
January 2025
NTTR-NCVC Bio Digital Twin Center, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Positive end-expiratory pressure (PEEP) improves respiratory conditions. However, the complex interaction between PEEP and hemodynamics in heart failure patients makes it challenging to determine appropriate PEEP settings. In this study, we developed a framework for the impact of PEEP on hemodynamics considering cardiac function, by integrating the impact of PEEP in the generalized circulatory equilibrium framework, and validated the framework by assessing its ability to accurately predict PEEP-induced hemodynamics.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!