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Title: Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: a cross-sectional, observational study
Authors: Sequerra, Eduardo Bouth
Rocha, Antonio Jhones Lima da
Medeiros, Galtieri Otavio Cunha de
Moreira Neto, Manuel
Maia, Claudia Rodrigues Souza
Arrais, Nívia Maria Rodrigues
Bezerra, Mylena Taíse Azevedo Lima
Jeronimo, Selma Maria Bezerra
Barros Filho, Allan Kardec Duailibe
Sousa, Patrícia S
Melo, Aurea Nogueira de
Queiroz, Claudio Marcos Teixeira de
Keywords: Epilepsy;Hypsarrhythmia;Sleep spindles;Microcephaly
Issue Date: Aug-2020
Publisher: Elsevier
Citation: SEQUERRA, E. B. et al. Association between brain morphology and electrophysiological features in Congenital Zika Virus Syndrome: a cross-sectional, observational study. EclinicalMedicine, [S. l.], ago. 2020. Doi: 10.1016/j.eclinm.2020.100508. Disponível em: Acesso em: 23 set. 2020.
Portuguese Abstract: 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
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