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NNP07 Hyperoxia causes cell death in the hippocampus of the developing brain
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Abstracts: Poster Presentations, the Seventh European Paediatric Neurology Society (EPNS) Congress
NNP04 Neurodevelopment of children born from mothers with chorioamnionitis S.H. Kurul1 *, U. Yis1 , E. Ozer2 . 1 Department of Pediatric Neurology, 2 Department of Pathology, Dokuz Eylul ¨ University, Izmir, Turkey
NNP06 Non-nutritive sucking in the high-risk preterm infant M. Hafstrom3 *, L. Kristoffersen1 , K. Grunewald1 , M. Rygg2 . 1 Department of Paediatrics, St Olavs Hospital, 2 Institute of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway, 3The Queen Silvia’s Childrens Hospital, Goteborg University, Goteborg, ¨ ¨ Sweden
The aim of this study is to examine the clinical features and neurological development of children born from mothers with chorioamnionitis and compare the neurological development with children whose mother did not have chorioamnionitis. Cases were selected randomly from the records of pathology department whose mother had a histological diagnosis of chorioamnionitis. Cases born from a mother with normal placenta examination were randomly selected as a control group. The psychomotor development was assessed using Denver test by the age of one year. A total of 54 cases were included in the study (30 cases in the chorioamnionitis group; 24 cases in the control group). The age of mother, risk factors during pregnancy, the way of birth and sex of cases did not differ between the two groups (p = 0.63, p = 0.82, p = 0.83 and p = 0.76, respectively). Although the mean birth week of cases did not differ statistically between the two groups (34.36±5.32 versus 38.25±1.48 weeks; p = 0.06), 15 cases (50%) were born prematurely in the chorioamnionitis group. The psychomotor development did not differ between the two groups (p = 0.2). Although chorioamnionitis led to premature birth and complications in newborn period, it does not seem to have an adverse effect on the psychomotor development.
Non-nutritive sucking (NNS) by the newborn infant is one of the first coordinated muscular activities in the foetus. The NNS pattern of altering bursts of sucking and pauses in healthy preterm infants show a gradual change with increased maturity. The purpose of this study was to examine if the NNS rhythm is affected in high-risk preterm infants. Method: A specially designed computer based method that records, identifies, analyses and quantifies the pressure signals obtained from a pressure transducer inside a pacifier when the infants suck was used. The NNS patterns from fifty-two preterm infants were analysed (GA Md 27+4 weeks) and 213 recordings were made. Significant cerebral pathology was found in 14 infants. Twenty-one infants had a broncopulmonary dysplasia (BPD). Results: A gradual change of the NNS pattern is seen with increased maturity; the infants’ sucking activity, duration of bursts, sucking frequency and frequency stability is increased. In infants with cerebral pathology a significant reduced sucking frequency and a less stable frequencyrhythm is observed. An increased severity of BPD correlates with lower sucking frequency and longer intervals between bursts. Conclusions: In preterm infants with cerebral pathology and/or BPD the NNS rhythm is modified.
NNP05 Post-asphyxial facio-mandibular tremor in neonates: a poor prognostic sign
NNP07 Hyperoxia causes cell death in the hippocampus of the developing brain
P.J. Cherian *, R.J. Veldhuizen, R.M. Swarte, P. Govaert, J.H. Blok, G.H. Visser. Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands, Department of Neonatology, Erasmus MC Sophia Children’s Hospital, University Medical Centre, Rotterdam, The Netherlands
S.H. Kurul1 *, U. Yis1 , A. Kumral2 , S. Cilaker3 , K. Tugyan3 , S. Genc4 , O. Yilmaz5 . 1 Department of Pediatric Neurology, 2 Department of Neonatology, 3 Department of Histology and Emryology, 4 Learning Resources Center Research Laboratory, 5 Experimental Animal Laboratory, Dokuz Eylul ¨ University, Izmir, Turkey
predictors of minor neurological dysfunction and behaviour problems in childhood
Purpose: To describe a clinical sign observed in neonates with severe hypoxic ischemic encephalopathy (HIE). Methods: We reviewed polygraphic EEG recordings with video, of 24−48 hour duration, from 80 neonates with birth asphyxia. Results: Tremor involving the perioral region and sometimes the chin, was observed in ten neonates. All ten had clinical features of severe HIE. Tremor artefact was best seen at the anterior temporal EEG electrodes, at 7−9.5 Hz, lasting for 6−16 sec. It recurred 5−37 (median 13) times in the first 30 minutes of the recording and was seen for a median duration of nine hours. The EEG background activity was severely abnormal in all ten babies. In two of them, the tremor could be elicited by tactile stimuli. In one newborn, neuromuscular blockade abolished the tremor and confirmed the absence of a scalp EEG correlate, thereby supporting its non-epileptic nature. Brain MRI showed cortical and subcortical abnormalities in six neonates; the other four had only subcortical abnormalities. Eight out of ten babies died in the neonatal period while 2 developed severe motor handicap. Conclusion: Facio-mandibular tremor in neonates after perinatal asphyxia appears to be a sign of severe brain damage and suggests poor prognosis.
Supraphysiological oxygen concentrations exert significant toxicity to the developing lungs and retina. However, there is little information about the effects of supraphysiological oxygen concentrations on the developing brain. The aim of this study is to investigate the effects of hyperoxia on hippocampus of the developing brain. Effects of hyperoxia were studied by exposing Wistar pups (n = 8) from birth until postnatal day 5 to 80% oxygen in a chamber controlled by an oxymeter. Control animals (n = 8) were maintained in room air (21% oxygen). Cell death was assessed with ELISA cell death assay, neuron counting and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) reaction. There was statistically significant difference between the study and control groups in regard to the neuronal density of hippocampus (34.5±2.87 versus 39.12±1.2; p = 0.001). There was also a significant increase in ELISA cell death assay in the cortex of the study group compared to the control group after five days exposure to hyperoxia (10.40±0.83 versus 9.19±0.48 absorbance gram protein; p = 0.001). The results show that, exposure of the developing brain to high concentrations of oxygen causes neuronal loss and an apoptotic neurodegenerative reaction in the hippocampus of the newborn rats.
Abstracts: Poster Presentations, the Seventh European Paediatric Neurology Society (EPNS) Congress
NNP04 Neurodevelopment of children born from mothers with chorioamnionitis S.H. Kurul1 *, U. Yis1 , E. Ozer2 . 1 Department of Pediatric Neurology, 2 Department of Pathology, Dokuz Eylul ¨ University, Izmir, Turkey
NNP06 Non-nutritive sucking in the high-risk preterm infant M. Hafstrom3 *, L. Kristoffersen1 , K. Grunewald1 , M. Rygg2 . 1 Department of Paediatrics, St Olavs Hospital, 2 Institute of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway, 3The Queen Silvia’s Childrens Hospital, Goteborg University, Goteborg, ¨ ¨ Sweden
The aim of this study is to examine the clinical features and neurological development of children born from mothers with chorioamnionitis and compare the neurological development with children whose mother did not have chorioamnionitis. Cases were selected randomly from the records of pathology department whose mother had a histological diagnosis of chorioamnionitis. Cases born from a mother with normal placenta examination were randomly selected as a control group. The psychomotor development was assessed using Denver test by the age of one year. A total of 54 cases were included in the study (30 cases in the chorioamnionitis group; 24 cases in the control group). The age of mother, risk factors during pregnancy, the way of birth and sex of cases did not differ between the two groups (p = 0.63, p = 0.82, p = 0.83 and p = 0.76, respectively). Although the mean birth week of cases did not differ statistically between the two groups (34.36±5.32 versus 38.25±1.48 weeks; p = 0.06), 15 cases (50%) were born prematurely in the chorioamnionitis group. The psychomotor development did not differ between the two groups (p = 0.2). Although chorioamnionitis led to premature birth and complications in newborn period, it does not seem to have an adverse effect on the psychomotor development.
Non-nutritive sucking (NNS) by the newborn infant is one of the first coordinated muscular activities in the foetus. The NNS pattern of altering bursts of sucking and pauses in healthy preterm infants show a gradual change with increased maturity. The purpose of this study was to examine if the NNS rhythm is affected in high-risk preterm infants. Method: A specially designed computer based method that records, identifies, analyses and quantifies the pressure signals obtained from a pressure transducer inside a pacifier when the infants suck was used. The NNS patterns from fifty-two preterm infants were analysed (GA Md 27+4 weeks) and 213 recordings were made. Significant cerebral pathology was found in 14 infants. Twenty-one infants had a broncopulmonary dysplasia (BPD). Results: A gradual change of the NNS pattern is seen with increased maturity; the infants’ sucking activity, duration of bursts, sucking frequency and frequency stability is increased. In infants with cerebral pathology a significant reduced sucking frequency and a less stable frequencyrhythm is observed. An increased severity of BPD correlates with lower sucking frequency and longer intervals between bursts. Conclusions: In preterm infants with cerebral pathology and/or BPD the NNS rhythm is modified.
NNP05 Post-asphyxial facio-mandibular tremor in neonates: a poor prognostic sign
NNP07 Hyperoxia causes cell death in the hippocampus of the developing brain
P.J. Cherian *, R.J. Veldhuizen, R.M. Swarte, P. Govaert, J.H. Blok, G.H. Visser. Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands, Department of Neonatology, Erasmus MC Sophia Children’s Hospital, University Medical Centre, Rotterdam, The Netherlands
S.H. Kurul1 *, U. Yis1 , A. Kumral2 , S. Cilaker3 , K. Tugyan3 , S. Genc4 , O. Yilmaz5 . 1 Department of Pediatric Neurology, 2 Department of Neonatology, 3 Department of Histology and Emryology, 4 Learning Resources Center Research Laboratory, 5 Experimental Animal Laboratory, Dokuz Eylul ¨ University, Izmir, Turkey
predictors of minor neurological dysfunction and behaviour problems in childhood
Purpose: To describe a clinical sign observed in neonates with severe hypoxic ischemic encephalopathy (HIE). Methods: We reviewed polygraphic EEG recordings with video, of 24−48 hour duration, from 80 neonates with birth asphyxia. Results: Tremor involving the perioral region and sometimes the chin, was observed in ten neonates. All ten had clinical features of severe HIE. Tremor artefact was best seen at the anterior temporal EEG electrodes, at 7−9.5 Hz, lasting for 6−16 sec. It recurred 5−37 (median 13) times in the first 30 minutes of the recording and was seen for a median duration of nine hours. The EEG background activity was severely abnormal in all ten babies. In two of them, the tremor could be elicited by tactile stimuli. In one newborn, neuromuscular blockade abolished the tremor and confirmed the absence of a scalp EEG correlate, thereby supporting its non-epileptic nature. Brain MRI showed cortical and subcortical abnormalities in six neonates; the other four had only subcortical abnormalities. Eight out of ten babies died in the neonatal period while 2 developed severe motor handicap. Conclusion: Facio-mandibular tremor in neonates after perinatal asphyxia appears to be a sign of severe brain damage and suggests poor prognosis.
Supraphysiological oxygen concentrations exert significant toxicity to the developing lungs and retina. However, there is little information about the effects of supraphysiological oxygen concentrations on the developing brain. The aim of this study is to investigate the effects of hyperoxia on hippocampus of the developing brain. Effects of hyperoxia were studied by exposing Wistar pups (n = 8) from birth until postnatal day 5 to 80% oxygen in a chamber controlled by an oxymeter. Control animals (n = 8) were maintained in room air (21% oxygen). Cell death was assessed with ELISA cell death assay, neuron counting and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) reaction. There was statistically significant difference between the study and control groups in regard to the neuronal density of hippocampus (34.5±2.87 versus 39.12±1.2; p = 0.001). There was also a significant increase in ELISA cell death assay in the cortex of the study group compared to the control group after five days exposure to hyperoxia (10.40±0.83 versus 9.19±0.48 absorbance gram protein; p = 0.001). The results show that, exposure of the developing brain to high concentrations of oxygen causes neuronal loss and an apoptotic neurodegenerative reaction in the hippocampus of the newborn rats.