EEG Spectral Power and Neurovascular Coupling as Early Predictors of Neurodevelopmental Outcome in Neonatal Hypoxic-Ischemic Encephalopathy.

Hypoxic ischemic encephalopathy (HIE) remains one of the leading causes of morbidity and mortality in newborns. There is a strong need to predict their neurodevelopmental impairment (NDI) within early hours of life, tailoring treatment strategies accordingly. This study aims to explore the discriminatory capabilities of electroencephalogram (EEG) delta power (DP) and total power (TP), along with neurovascular coupling (NVC) to predict NDI. The study evaluates the relationships of single biomarkers (DP, TP, and NVC) with NDI using univariate logistic regression models. The predictive accuracy of single (DP, TP, and NVC) and combination of biomarkers (DP+NVC, TP+NVC) on NDI is further assessed through the receiver operating characteristic (ROC) curve, with the area under the ROC curve (AUC). Utilizing EEG and near infrared spectroscopy (NIRS) data from 35 newborns with mild and moderate HIE, we found that a one-unit increase in DP or TP significantly lowered the odds of NDI. The combination of DP or TP and NVC is most effective in distinguishing newborns who may develop NDI. These findings suggest that continuous multimodal real-time neuromonitoring could offer valuable insights into HIE severity, aiding in predicting brain injury and NDI.