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. 2023 Mar 2:17:1105638.
doi: 10.3389/fnins.2023.1105638. eCollection 2023.

Associations between neurological examination at term-equivalent age and cerebral hemodynamics and oxygen metabolism in infants born preterm

Gabriel Côté-Corriveau  1   2   3 , Marie-Noëlle Simard  1   4 , Olivia Beaulieu  1 , Rasheda Arman Chowdhury  1   5 , Marie-Michèle Gagnon  1 , Mélanie Gagnon  1 , Omar Ledjiar  6 , Catherine Bernard  1 , Anne Monique Nuyt  1   3 , Mathieu Dehaes  1   5   7 , Thuy Mai Luu  1   3
Affiliations

Associations between neurological examination at term-equivalent age and cerebral hemodynamics and oxygen metabolism in infants born preterm

Gabriel Côté-Corriveau et al. Front Neurosci. .

Abstract

Background: Infants born at 29-36 weeks gestational age (GA) are at risk of experiencing neurodevelopmental challenges. We hypothesize that cerebral hemodynamics and oxygen metabolism measured by bedside optical brain monitoring are potential biomarkers of brain development and are associated with neurological examination at term-equivalent age (TEA).

Methods: Preterm infants (N = 133) born 29-36 weeks GA and admitted in the neonatal intensive care unit were enrolled in this prospective cohort study. Combined frequency-domain near infrared spectroscopy (FDNIRS) and diffuse correlation spectroscopy (DCS) were used from birth to TEA to measure cerebral hemoglobin oxygen saturation and an index of microvascular cerebral blood flow (CBF i ) along with peripheral arterial oxygen saturation (SpO2). In combination with hemoglobin concentration in the blood, these parameters were used to derive cerebral oxygen extraction fraction (OEF) and an index of cerebral oxygen metabolism (CMRO2i ). The Amiel-Tison and Gosselin Neurological Assessment was performed at TEA. Linear regression models were used to assess the associations between changes in FDNIRS-DCS parameters from birth to TEA and GA at birth. Logistic regression models were used to assess the associations between changes in FDNIRS-DCS parameters from birth to TEA and neurological examination at TEA.

Results: Steeper increases in CBF i (p < 0.0001) and CMRO2i (p = 0.0003) were associated with higher GA at birth. Changes in OEF, CBF i , and CMRO2i from birth to TEA were not associated with neurological examination at TEA.

Conclusion: In this population, cerebral FDNIRS-DCS parameters were not associated with neurological examination at TEA. Larger increases in CBF i and CMRO2i from birth to TEA were associated with higher GA. Non-invasive bedside FDNIRS-DCS monitoring provides cerebral hemodynamic and metabolic parameters that may complement neurological examination to assess brain development in preterm infants.

Keywords: brain development; cerebral blood flow; cerebral oxygen metabolism; diffuse correlation spectroscopy; frequency-domain near infrared spectroscopy; neurological examination; preterm birth.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of participants.
FIGURE 2
FIGURE 2
Associations between temporal changes of (A) cerebral blood flow index (CBFi), (B) cerebral metabolic rate of oxygen consumption index (CMRO2i), and (C) cerebral oxygen extraction fraction (OEF) with gestational age at birth (GA). For each parameter, a linear fit (blue line) and corresponding correlation coefficient (R2) and p-value are provided.
See this image and copyright information in PMC

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