Neonatal spectral EEG is prognostic of cognitive abilities at school age in premature infants without overt brain damage

Prematurity is a prototype of biological risk that could affect the late neurocognitive outcome; however, the condition itself remains a non-specific marker. This longitudinal 6-year study aimed to evaluate the prognostic role of neonatal spectral EEG in premature infants without neurological complications. The study cohort was 26 children born 23–34 gestational ages; all neonates underwent multichannel EEG recordings at 35 weeks post-conception. EEG data were transformed into the frequency domain and divided into delta (0.5–4 Hz), theta (5–7 Hz), alpha (8–13 Hz), and beta (14–20 Hz) frequency bands. At 6 years, a neuropsychological and behavioral evaluation was performed. Correlations between spectral bands and neuropsychological assessments were performed with a conservative and robust Bayesian correlation model using weakly informative priors. The correlation of neuropsychological tasks to spectral frequency bands highlighted a significant association with visual and auditory attention tests. The performance on the same tests appears to be mainly impaired. Conclusions: We found that spectral EEG frequencies are independent predictors of performance in attention tasks. We hypothesized that spectral EEG might reflect early circuitries’ imbalance in the reticular ascending system and cumulative effect on ongoing development, pointing to the importance of early prognostic instruments.What is Known:• Prematurity is a non-specific marker of late neurocognitive risk.• Precise prognostic instruments are lacking, mostly in patients with low-grade conditions.What is New:• Longitudinal long-term studies are scarce but crucial for the inferential attributive process.• Spectral EEG frequencies are independent predictors of performance in attention tasks.