Study objectives: Unobtrusive monitoring of sleep and sleep disorders in children presents challenges. We investigated the possibility of using Ultra-Wide band (UWB) radar to measure sleep in children. Methods: Thirty-two children scheduled to undergo a clinical polysomnography participated; their ages ranged from 2 months to 14 years. During the polysomnography, the children's body movements and breathing rate were measured by an UWB-radar. A total of 38 features were calculated from the motion signals and breathing rate obtained from the raw radar signals. Adaptive boosting was used as machine learning classifier to estimate sleep stages, with polysomnography as gold standard method for comparison. Results: Data of all participants combined, this study achieved a Cohen's Kappa coefficient of 0.67 and an overall accuracy of 89.8% for wake and sleep classification, a Kappa of 0.47 and an accuracy of 72.9% for wake, rapid-eye-movement (REM) sleep, and non-REM sleep classification, and a Kappa of 0.43 and an accuracy of 58.0% for wake, REM sleep, light sleep and deep sleep classification. Conclusion: Although the current performance is not sufficient for clinical use yet, UWB radar is a promising method for non-contact sleep analysis in children.

BACKGROUND AND PURPOSE: Infants born preterm are commonly diagnosed with structural brain lesions known to affect long-term neurodevelopment negatively. Yet, the effects of preterm birth on brain development in the absence of intracranial lesions remain to be studied in detail. In this study, we aim to quantify long term consequences of preterm birth on brain development in this specific group. MATERIALS AND METHODS: Neonatal cranial sonography and follow-up T1-weighted MR imaging and DTI were performed to evaluate whether the anatomic characteristics of the cerebrum and cerebellum in a cohort of school-aged children (6 -12 years of age) were related to gestational age at birth in children free of brain lesions in the perinatal period. RESULTS: In the cohort consisting of 36 preterm (28-37 weeks' gestational age) and 66 term-born infants, T1-weighted MR imaging and DTI at 6-12 years revealed a reduction of cerebellar white matter volume (β=0.387, P=.001), altered fractional anisotropy of cerebellar white matter (β=-0.236, P=.02), and a reduction of cerebellar gray and white matter surface area (β=0.337, P=.001;β=0.375, P<.001, respectively) in relation to birth age. Such relations were not observed for the cerebral cortex or white matter volume, surface area, or diffusion quantities. CONCLUSIONS: The results of our study show that perinatal influences that are not primarily neurologic are still able to disturb long-term neurodevelopment, particularly of the developing cerebellum. Including the cerebellum in future neuroprotective strategies seems therefore essential.

Ultrasound is a superb neonatal neuroimaging technique as it is non-invasive, easily accessible and safe. Ultrasound is still seen as complementary to other neonatal neuroimaging techniques (such as MRI) because it still lacks several important neuroimaging features such as quantitative tissue analysis. However, developments in ultrasound technology are predicted to follow each other in rapid succession and are expected to have a major impact on clinical neonatal cerebral ultrasound applications in the near future. Elastography, Ultrafast Doppler, Shear Wave imaging, Contrast Enhanced ultrasound and functional ultrasound are examples of techniques being discussed. The aim of this review is to provide a compact overview of current ultrasound developments which are likely to have an impact on neonatal cerebral ultrasound use.

Reference ranges for regional cerebral tissue oxygen saturation (crSO 2) reported by Pichler et al are an important step towards implementation of crSO2 monitoring during resuscitations. 1 At the Erasmus Medical Centre, Rotterdam, we found a surprising crSO2 observation in the first 10 infants (26 4/ 7 weeks [26 3/ 7-27 1/ 4], birth weight 910 g [705-960g]) that we evaluated. They had very low initial crSO 2 (15% [15-15%] [median {IQR}]). Because there is so little variation at the start of the resuscitation there is no variance in the IQR, as can be seen in the Figure. The Figure shows the observed values in relation to the percentiles published by Pichler et al. 1 Infants were resuscitated according to local guidelines, based upon European Resuscitation Council guidelines. 2 Arterial oxygen saturation was measured with a Nellcor N600-x pulseoximeter, and crSO 2 was measured with an Invos 5100C (Covidien, Dublin, Ireland). During resuscitation, SpO 2 and Apgar scores were similar to prior observations at our institution. 2 Infants left the resuscitation area with crSO 2 of 59% (47%-64%).