MRI and spectroscopy in (near) term neonates with perinatal asphyxia and therapeutic hypothermia

Alderliesten, Thomas; Vries, Linda S. de; Staats, Liza; Haastert, Ingrid C. van; Weeke, Lauren C.; Benders, Manon J. N. L.; Koopman-Esseboom, Corine; Groenendaal, Floris

doi:10.1136/archdischild-2016-310514

Cited by 60 publications

(65 citation statements)

References 32 publications

(35 reference statements)

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“…Ten patients (18.5%) were graded as having mild HIE. We found this proportion of patients with mild HIE in a similar manner as reported in previous studies [8,22]. …”

Section: Discussionsupporting

confidence: 79%

“…There was also a small number of neonates who experienced adverse outcomes (21%), which is lower than in our study (32%) and in other previous studies (30-46%) with larger sample sizes [20,21]. Alderliesten et al [22] measured ADC values in 88 newborns with HIE who were treated with TH. MRI was performed on a 1.5-T ( n = 38) or 3.0-T ( n = 50) MR system from 2.5 to 6 days of life.…”

Section: Discussioncontrasting

confidence: 49%

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Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia

Heursen

Ojeda

Fernández³

et al. 2017

Neonatology

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Background: Apparent diffusion coefficient (ADC) quantification has been proven to be of prognostic value in term newborns with hypoxic-ischaemic encephalopathy (HIE) who were treated under normothermia. Objectives: To evaluate the prognostic value of ADC in standardized brain regions in neonates with HIE who were treated with therapeutic hypothermia (TH). Methods: This prospective cohort study included 54 term newborns who were admitted with HIE and treated with TH. All magnetic resonance imaging examinations were performed between days 4 and 6 of life, and ADC values were measured in 13 standardized regions of the brain. At 2 years of age we explored whether ADC values were related to composite outcomes (death or survival with abnormal neurodevelopment). Results: The severity of HIE is inversely related to ADC values in different brain regions. We found that lower ADC values in the posterior limb of the internal capsule (PLIC), the thalami, the semioval centre, and frontal and parietal white matter were related to adverse outcomes. ADC values in the PLIC and thalami are good predictors of adverse outcomes (AUC 0.86 and 0.76). Conclusions: Low ADC values in the PLIC, thalamus, semioval centre, and frontal and parietal white matter in full-term infants with HIE treated with TH were associated with a poor outcome.

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“…Ten patients (18.5%) were graded as having mild HIE. We found this proportion of patients with mild HIE in a similar manner as reported in previous studies [8,22]. …”

Section: Discussionsupporting

confidence: 79%

Section: Discussioncontrasting

confidence: 49%

Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia

Heursen

Ojeda

Fernández³

et al. 2017

Neonatology

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show abstract

“…Since TH affects cerebral metabolism, it might alter the prognostic accuracy of 1 H MRS for the long-term outcome. Nonetheless, in a recent study, there was a strong association between the neurodevelopmental outcome at ≥ 2 years and the Lac/NAA ratio during the first week of life in infants with perinatal asphyxia treated with TH [35] .…”

Section: Therapeutic Hypothermiamentioning

confidence: 99%

Neuroprotective Treatments after Perinatal Hypoxic-Ischemic Brain Injury Evaluated with Magnetic Resonance Spectroscopy

Berger

Brekke²,

Widerøe³

et al. 2017

Dev Neurosci

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Perinatal hypoxic-ischemic brain injury is a major health problem. Adjuvant treatments that improve the neuroprotective effect of the current treatment, therapeutic hypothermia, are urgently needed. The growing knowledge about the complex pathophysiology of hypoxia-ischemia (HI) has led to the discovery of several important targets for neuroprotection. Early interventions should focus on the preservation of energy metabolism, the reduction of glutamate excitotoxicity and oxidative stress, the maintenance of calcium homeostasis, and the prevention of apoptosis. Delayed interventions should promote injury repair. The multiple metabolic changes following HI as well as the metabolic effects of potential treatments can be observed noninvasively by magnetic resonance spectroscopy (MRS). This mini-review provides an overview of the neuroprotective pharmacological agents that have been evaluated with ¹H/³¹P/¹³C MRS. A better understanding of how these agents influence cerebral metabolism and the use of relevant translational MRS biomarkers can guide future clinical trials.

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“…o The features extracted from diffusion-weighted MRI (DW-MRI) and proton magnetic resonance spectroscopy (H-MRS), such as apparent diffusion coefficient (ADC) of the basal ganglia and thalamus, lactate/N-acetylaspartate (LAC/NAA) and Nacetylaspartate/choline (NAA/Cho) [210], brain volume [243] and white and grey matter lesions [244], could be useful. However, the best time to undertake MRI is 7-10 days and earlier imaging may under-or over-estimate the degree of brain injury [205].…”

Section: Limitations Of the Study And Proposed Recommendationsmentioning

confidence: 99%

“…Laptook et al [206] and Mirsa et al [207] reported ratios extracted from diffusion-weighted MRI (DW-MRI) and proton magnetic resonance spectroscopy (H-MRS) with neurodevelopmental outcome [210]. The optimal timing of an MRI examination for prognosis of outcome in newborns with HIE is the second week of life and therefore its use for early prognostication may be limited [205].…”

Section: Introductionmentioning

confidence: 99%

Design and optimisation of time-frequency analysis for multichannel neonatal EEG background features in term neonates with hypoxic ischaemic encephalopathy: characterisation, classification and neurodevelopmental outcome prediction

Awal¹

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Neonatal Hypoxic Ischaemic Encephalopathy (HIE) is a major cause of morbidity and mortality in newborns throughout the world with an incidence of 1-8/1000 newborns in developed countries and up to 26/1000 newborns in developing countries. It causes one million neonatal deaths globally per year. Electroencephalography (EEG) is a useful method for assessment of brain activity in newborns with HIE. EEG performs well in the early diagnosis and classification of HIE severity and in predicting neurodevelopmental outcome. A normal EEG is highly predictive of a normal outcome and various abnormal EEG features are associated with neurological abnormalities or death.A systematic review and meta-analysis of the literature was undertaken to determine which specific background features of the EEG best predict outcome (Aim 1). Automatic detection and classification

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MRI and spectroscopy in (near) term neonates with perinatal asphyxia and therapeutic hypothermia

Abstract: During and after therapeutic hypothermia, low ADC values and high Lac/NAA ratios of the basal ganglia and thalamus are associated with an adverse outcome in infants with perinatal asphyxia.

Cited by 60 publications

References 32 publications

Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia

Prognostic Value of the Apparent Diffusion Coefficient in Newborns with Hypoxic-Ischaemic Encephalopathy Treated with Therapeutic Hypothermia

Neuroprotective Treatments after Perinatal Hypoxic-Ischemic Brain Injury Evaluated with Magnetic Resonance Spectroscopy

Design and optimisation of time-frequency analysis for multichannel neonatal EEG background features in term neonates with hypoxic ischaemic encephalopathy: characterisation, classification and neurodevelopmental outcome prediction

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