A Bayesian parametric model for quantifying brain maturation from sleep-EEG in the vulnerable newborn baby

Newborn babies, particularly preterms, can exhibit early deviations in sleep maturation as seen by Electroencephalogram (EEG) recordings. This may be indicative of cognitive problems by school-age. The current ‘clinically-driven’ approach uses separate algorithms to first extract sleep states and then predict EEG ‘brain-age’. Maturational deviations are identified when the brain-age no longer matches the Postmenstrual Age (PMA, the age since the last menstrual cycle of the mother). However, the PMA range where existing sleep staging algorithms perform optimally, is limited, which subsequently limits the PMA range for brain-age prediction. We introduce a Bayesian Parametric Model (BPM) as a single end-to-end solution to directly estimate brain-age, modelling for sleep state maturation without requiring a separately optimized sleep staging algorithm. Comparison of this model with a traditional multi-stage approach, yields a similar Krippendorff’s $\alpha = 0.92$ (a performance measure ranging from 0 (chance agreement) to 1 (perfect agreement)) with the BPM performing better at younger ages <30 weeks PMA. The BPM’s potential to detect maturational deviations is also explored on a few preterm babies who were abnormal at 9 months follow-up.

[1]  W. Marsden I and J , 2012 .

[2]  Sabine Van Huffel,et al.  Complexity Analysis of Neonatal EEG Using Multiscale Entropy: Applications in Brain Maturation and Sleep Stage Classification , 2017, Entropy.

[3]  S. Vanhatalo,et al.  Automated classification of neonatal sleep states using EEG , 2017, Clinical Neurophysiology.

[4]  Klaus Krippendorff,et al.  Agreement and Information in the Reliability of Coding , 2011 .

[5]  Sabine Van Huffel,et al.  An Automated Quiet Sleep Detection Approach in Preterm Infants as a Gateway to Assess Brain Maturation , 2017, Int. J. Neural Syst..

[6]  Steven P. Miller,et al.  Brain injury in premature neonates: A primary cerebral dysmaturation disorder? , 2014, Annals of neurology.

[7]  J. Oosterlaan,et al.  Meta-Analysis of Neurobehavioral Outcomes in Very Preterm and/or Very Low Birth Weight Children , 2009, Pediatrics.

[8]  Sabine Van Huffel,et al.  Review of sleep-EEG in preterm and term neonates. , 2017, Early human development.

[9]  N. J. Stevenson,et al.  Functional maturation in preterm infants measured by serial recording of cortical activity , 2017, Scientific Reports.

[10]  Geoffrey J. McLachlan,et al.  Finite Mixture Models , 2019, Annual Review of Statistics and Its Application.

[11]  Klaus Krippendorff,et al.  Answering the Call for a Standard Reliability Measure for Coding Data , 2007 .

[12]  M. Grigg‐Damberger,et al.  The Visual Scoring of Sleep in Infants 0 to 2 Months of Age. , 2016, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[13]  S. Graven Sleep and brain development. , 2006, Clinics in perinatology.

[14]  Sabine Van Huffel,et al.  Automated EEG sleep staging in the term-age baby using a generative modelling approach , 2018, Journal of neural engineering.