Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study
Background: Intrauterine infection with the Zika virus (ZIKV) has been connected to severe brain malformations, microcephaly, and abnormal electrophysiological activity. Methods: We describe the interictal electroencephalographic (EEG) recordings of 47 children born with ZIKV-derived microcephaly. E...
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Elsevier
2020-09-01
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Series: | EClinicalMedicine |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537020302522 |
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doaj-e9a95e5957054dcc9ce3ad1fffdef667 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Eduardo B Sequerra Antonio J Rocha Galtieri O C de Medeiros Manuel M Neto Claudia R S Maia Nívia M R Arrais Mylena Bezerra Selma M B Jeronimo Allan Kardec Barros Patrícia S Sousa Aurea Nogueira de Melo Claudio M Queiroz |
spellingShingle |
Eduardo B Sequerra Antonio J Rocha Galtieri O C de Medeiros Manuel M Neto Claudia R S Maia Nívia M R Arrais Mylena Bezerra Selma M B Jeronimo Allan Kardec Barros Patrícia S Sousa Aurea Nogueira de Melo Claudio M Queiroz Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study EClinicalMedicine Epilepsy Hypsarrhythmia Sleep spindles Infants Microcephaly |
author_facet |
Eduardo B Sequerra Antonio J Rocha Galtieri O C de Medeiros Manuel M Neto Claudia R S Maia Nívia M R Arrais Mylena Bezerra Selma M B Jeronimo Allan Kardec Barros Patrícia S Sousa Aurea Nogueira de Melo Claudio M Queiroz |
author_sort |
Eduardo B Sequerra |
title |
Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study |
title_short |
Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study |
title_full |
Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study |
title_fullStr |
Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study |
title_full_unstemmed |
Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational study |
title_sort |
association between brain morphology and electrophysiological features in congenital zika virus syndrome: a cross-sectional, observational study |
publisher |
Elsevier |
series |
EClinicalMedicine |
issn |
2589-5370 |
publishDate |
2020-09-01 |
description |
Background: Intrauterine infection with the Zika virus (ZIKV) has been connected to severe brain malformations, microcephaly, and abnormal electrophysiological activity. Methods: We describe the interictal electroencephalographic (EEG) recordings of 47 children born with ZIKV-derived microcephaly. EEGs were recorded in the first year of life and correlated with brain morphology. In 31 subjects, we tested the association between computed tomography (CT) findings and interictal epileptiform discharges (IED). In eighteen, CTs were used for correlating volumetric measurements of the brainstem, cerebellum, and prosencephalon with the rate of IED. Findings: Twenty-nine out of 47 (62%) subjects were diagnosed as having epilepsy. Those subjects presented epileptiform discharges, including unilateral interictal spikes (26/29, 90%), bilateral synchronous and asynchronous interictal spikes (21/29, 72%), and hypsarrhythmia (12/29, 41%). Interestingly, 58% of subjects with clinical epilepsy were born with rhombencephalon malformations, while none of the subjects without epilepsy showed macroscopic abnormalities in this region. The presence of rhombencephalon malformation was associated with epilepsy (odds ratio of 34; 95% CI: 2 - 654). Also, the presence of IED was associated with smaller brain volumes. Age-corrected total brain volume was inversely correlated with the rate of IED during sleep. Finally, 11 of 44 (25%) subjects presented sleep spindles. We observed an odds ratio of 0·25 (95% CI: 0·06 - 1·04) for having sleep spindles given the IED presence. Interpretation: The findings suggest that certain CT imaging features are associated with an increased likelihood of developing epilepsy, including higher rates of IED and impaired development of sleep spindles, in the first year of life of CZVS subjects. Funding: This work was supported by the Brazilian Federal Government through a postdoctoral fellowship for EBS (Talented Youth, Science without Borders), an undergraduate scholarship for AJR (Institutional Program of Science Initiation Scholarships, Federal University of Rio Grande do Norte, Brazil), by International Centre for Genetic Engineering and Biotechnology (CRP/BRA18–05_EC) and by CAPES (Grant number 440893/2016-0), and CNPq (Grant number 88881.130729/2016-01). |
topic |
Epilepsy Hypsarrhythmia Sleep spindles Infants Microcephaly |
url |
http://www.sciencedirect.com/science/article/pii/S2589537020302522 |
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doaj-e9a95e5957054dcc9ce3ad1fffdef6672020-11-25T03:43:03ZengElsevierEClinicalMedicine2589-53702020-09-0126100508Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: A cross-sectional, observational studyEduardo B Sequerra0Antonio J Rocha1Galtieri O C de Medeiros2Manuel M Neto3Claudia R S Maia4Nívia M R Arrais5Mylena Bezerra6Selma M B Jeronimo7Allan Kardec Barros8Patrícia S Sousa9Aurea Nogueira de Melo10Claudio M Queiroz11Brain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, BrazilBrain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, BrazilImaging Diagnostic Center, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, BrazilImaging Diagnostic Center, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, BrazilDepartment of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, BrazilDepartment of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, BrazilDepartment of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, BrazilInstitute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil; National Institute of Science and Technology of Tropical Diseases, Natal, RN, BrazilDepartment of Electrical Engineering, Federal University of Maranhão, 65080-040 São Luís, MA, BrazilBrain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil; Department of Electrical Engineering, Federal University of Maranhão, 65080-040 São Luís, MA, BrazilDepartment of Pediatrics, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, 59012-300 Natal, RN, BrazilBrain Institute, Federal University of Rio Grande do Norte, 59056-450 Natal, RN, Brazil; Corresponding author.Background: Intrauterine infection with the Zika virus (ZIKV) has been connected to severe brain malformations, microcephaly, and abnormal electrophysiological activity. Methods: We describe the interictal electroencephalographic (EEG) recordings of 47 children born with ZIKV-derived microcephaly. EEGs were recorded in the first year of life and correlated with brain morphology. In 31 subjects, we tested the association between computed tomography (CT) findings and interictal epileptiform discharges (IED). In eighteen, CTs were used for correlating volumetric measurements of the brainstem, cerebellum, and prosencephalon with the rate of IED. Findings: Twenty-nine out of 47 (62%) subjects were diagnosed as having epilepsy. Those subjects presented epileptiform discharges, including unilateral interictal spikes (26/29, 90%), bilateral synchronous and asynchronous interictal spikes (21/29, 72%), and hypsarrhythmia (12/29, 41%). Interestingly, 58% of subjects with clinical epilepsy were born with rhombencephalon malformations, while none of the subjects without epilepsy showed macroscopic abnormalities in this region. The presence of rhombencephalon malformation was associated with epilepsy (odds ratio of 34; 95% CI: 2 - 654). Also, the presence of IED was associated with smaller brain volumes. Age-corrected total brain volume was inversely correlated with the rate of IED during sleep. Finally, 11 of 44 (25%) subjects presented sleep spindles. We observed an odds ratio of 0·25 (95% CI: 0·06 - 1·04) for having sleep spindles given the IED presence. Interpretation: The findings suggest that certain CT imaging features are associated with an increased likelihood of developing epilepsy, including higher rates of IED and impaired development of sleep spindles, in the first year of life of CZVS subjects. Funding: This work was supported by the Brazilian Federal Government through a postdoctoral fellowship for EBS (Talented Youth, Science without Borders), an undergraduate scholarship for AJR (Institutional Program of Science Initiation Scholarships, Federal University of Rio Grande do Norte, Brazil), by International Centre for Genetic Engineering and Biotechnology (CRP/BRA18–05_EC) and by CAPES (Grant number 440893/2016-0), and CNPq (Grant number 88881.130729/2016-01).http://www.sciencedirect.com/science/article/pii/S2589537020302522EpilepsyHypsarrhythmiaSleep spindlesInfantsMicrocephaly |