Quantitative EEG analysis in neonatal hypoxic ischaemic encephalopathy

ObjectiveTo test the hypothesis that quantitative EEG (qEEG) measures are associated with a grading of HIE based on the visual interpretation of neonatal EEG (EEG/HIE).MethodsContinuous multichannel video-EEG data were recorded for up to 72 h. One-hour EEG segments from each recording were visually analysed and graded by two electroencephalographers (EEGers) blinded to clinical data. Several qEEG measures were calculated for each EEG segment. Kruskal–Wallis testing with post hoc analysis and multiple linear regression were used to assess the hypothesis.ResultsFifty-four full-term infants with HIE were studied. The relative delta power, skewness, kurtosis, amplitude, and discontinuity were significantly different across four EEG/HIE grades (p < 0.05). A linear combination of these qEEG measures could predict the EEG/HIE grade assigned by the EEGers with an accuracy of 89%.ConclusionQuantitative analysis of background EEG activity has shown that measures based on the amplitude, frequency content and continuity of the EEG are associated with a visual interpretation of the EEG performed by experienced EEGers.SignificanceIdentifying qEEG measures that can separate between EEG/HIE grades is an important first step towards creating a classifier for automated detection of EEG/HIE grades.

► We examine the ability of several quantitative EEG measures to discriminate between EEG grades of HIE. ► Quantitative EEG measures are chosen to replicate the neurophysiologist’s approach when visually classifying full term neonatal EEG. ► EEG measures of amplitude and continuity of the EEG signal are the best performing measures in distinguishing between EEG/HIE grades. ► No single quantitative measure is capable of discriminating between all EEG/HIE grades. ► This study demonstrates the potential to simplify interpretation of neonatal EEG in HIE.