Systematically lower aEEG amplitude values in neurologically healthy children using an automated algorithm compared to a semi-manual method Age-related amplitude values from two aEEG assessments – do we need adjusted reference values for different aEEG calculations?

Sandra Greve^1*Pia Brensing¹Julia Wichlacz¹Christian Dohna-Schwake¹Ursula Felderhoff-Müser¹Luisa Paul²Nora Bruns¹

• ¹Essen University Hospital, Essen, Germany
• ²Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Baden-Württemberg, Germany

Objective The objective of the this study was to compare different modes of amplitude-integrated EEG (aEEG) assessment (semi-manual versus automated) in children. Methods A total of 450 unremarkable pediatric EEGs from children aged 6 months to 17.9 years were converted into aEEGs and the medians and means of the upper and lower amplitudes C3–P3, C4–P4, C3–C4, P3– This is a provisional file, not the final typeset article P4, Fp1–Fp2) were(channels C3 – P3, C4 – P4, C3 – C4, P3 – P4, Fp1 – Fp2) determined. The agreement of the semi-manual versus and automated measurements was assessed using via the Pearson correlation coefficients (PCC) and Bland-Altman plots. Mean differences between the methods and age-specific percentiles (5th-95th) were calculated. Results Semi-manually measured amplitudes were systematically higher greater than automated assessments. Mean differences of the means ranged between 23.7 and 29.3 µV for the upper and between 2.4 and 4.4 µV for the lower amplitudes depending on the channel. The PCC ranged between 0.68 and 0.92 for the upper and lower amplitudes of the mean depending on the channel. Age-specific percentiles showed different absolute values but similar trends. Conclusion AEEG amplitude values systematically differ between semi-manual and automated assessment. Age-related trends are evident despite differences in the absolute values. Reference values for different measurement techniques are needed for paediatric aEEG.