A growth chart of brain function from infancy to adolescence based on EEG

Abstract

Background: In children, objective, quantitative tools that determine functional neurodevelopment are scarce and rarely scalable for clinical use. Direct recordings of cortical activity using routinely acquired electroencephalography (EEG) offer reliable measures of brain function.; Methods: We developed and validated a measure of functional brain age (FBA) using a residual neural network-based interpretation of the paediatric EEG. In this cross-sectional study, we included 1056 children with typical development ranging in age from 1 month to 18 years. We analysed a 10- to 15-min segment of 18-channel EEG recorded during light sleep (N1 and N2 states).; Findings: The FBA had a weighted mean absolute error (wMAE) of 0.85 years (95% CI: 0.69-1.02; n = 1056). A two-channel version of the FBA had a wMAE of 1.51 years (95% CI: 1.30-1.73; n = 1056) and was validated on an independent set of EEG recordings (wMAE = 2.27 years, 95% CI: 1.90-2.65; n = 723). Group-level maturational delays were also detected in a small cohort of children with Trisomy 21 (Cohen's d = 0.36, p = 0.028).; Interpretation: A FBA, based on EEG, is an accurate, practical and scalable automated tool to track brain function maturation throughout childhood with accuracy comparable to widely used physical growth charts.; Funding: This research was supported by the National Health and Medical Research Council, Australia, Helsinki University Diagnostic Center Research Funds, Finnish Academy, Finnish Paediatric Foundation, and Sigrid Juselius Foundation.; Competing Interests: Declaration of interests J.A.R and S.V. hold a licensed patent on the burst metrics used in this paper. J.A.R. declares grants received from The Margaret Pemberton Foundation and the receipt of EEG equipment from Cadwell Industries. J.C. declares grants received from the following funding bodies: Medical Research Fund (MRFF), National Health and Medical Research Council (NHMRC), Children's Hospital Foundation Fellowship. J.C. acknowledges paid lectures for the Sleep Health Foundation. K.K.I., A.K., M.W., S.J.V., L.L, L.M.H. and N.J.S declare no competing interests. (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)