Original article| Volume 36, ISSUE 2, P116-123, February 2014

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Drug effects on endogenous brain activity in preterm babies

  • Kaija Malk
    Department of Children’s Clinical Neurophysiology, Helsinki University Central Hospital, Helsinki, Finland
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  • Marjo Metsäranta
    Chidren’s hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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  • Sampsa Vanhatalo
    Corresponding author. Address: Department of Clinical Neurophysiology, Helsinki University Central Hospital (HUCH), P.O. Box 280, FIN-00029 HUS, Finland. Tel.: +358 50 5286119; fax: +358 10 2960116.
    Department of Children’s Clinical Neurophysiology, Helsinki University Central Hospital, Helsinki, Finland

    Department of Neurological Sciences, University of Helsinki, Finland
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Published:February 19, 2013DOI:


      Background: Animal experiments have suggested that the quality of the early intermittent brain activity is important for shaping neuronal connectivity during developmental phase that corresponds to early prematurity. This is a pilot study aiming to assess whether spontaneous activity transients (SAT) in the early preterm babies are affected by drugs that are routinely used in neonatal intensive care. Methods: We collected retrospectively seventeen EEG recordings (15 babies, conceptional age 26–33 weeks, no brain lesions) that were divided into groups according to drug administration at the time of EEG: phenobarbital, fentanyl, theophylline, and controls. SATs were extracted from the EEG for further analysis with several advanced time-series analysis paradigms. Results: The visual appearance of SATs was unaffected by drugs. Phenobarbital reduced the total power of the SAT events. Both fentanyl and phenobarbital reduced the length of SATs, and enhanced the oscillations at higher frequencies. Theophylline reduced the oscillatory activity at middle frequencies during SAT, but enhanced oscillations at higher frequencies during time-period prior to SAT. Conclusions: Our findings suggest, that (i) all drugs examined affect brain activity in ways that are not seen in the visual EEG interpretation, and that (ii) both acute and long term (i.e. developmental) effects of these drugs on brain may warrant more attention as a part of optimizing preterm neurological care.


      EEG (electroencephalography), aEEG (amplitude integrated electroencephalography), ELBW (extremely low birth weight), SAT (spontaneous activity transient), iSAT (inter-SAT), F-C (fronto-central derivation), NICU (neonatal intensive care unit), TF (time–frequency analysis), RMS (root mean square), F (fentanyl), PH (phenobarbital), TP (theophylline), GABA (γ-aminobutyric acid), CO2 (carbon dioxide)


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