Paul E Sijens1, Katharina Wischniowsky2, Hendrik J Ter Horst2. 1. Department of Radiology, Division of Neonatology, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9713 GZ, The Netherlands. Electronic address: p.e.sijens@umcg.nl. 2. Department of Pediatrics, Division of Neonatology, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9713 GZ, The Netherlands.
Abstract
OBJECTIVE: The purpose of this study was to correlate brain metabolism assessed shortly after therapeutic hyperthermia by 1H magnetic resonance spectroscopy (MRS), with neurodevelopmental outcome. METHODS: At the age of 6.0±1.8days, brain metabolites of 35 term asphyxiated newborns, treated with therapeutic hypothermia, were quantified by multivoxel proton MRS of a volume cranial to the corpus callosum, containing both gray and white matter. At the age of 30months the Bayley Scale of Infant Development-III was performed. RESULTS: Infants that died had lower gray matter NAA levels than infants that survived (P=0.005). In surviving infants (28 of 35) there was a trend of negative correlation between gray matter choline levels and gross motor outcome (r=-0.45). In the white matter, choline correlated negatively with fine motor skills (r=-0.40), and creatine positively with gross motor skills (r=0.58, P=0.02). There was no relationship between lactate levels and outcome. CONCLUSION: MRS of asphyxiated neonates treated by therapeutic hypothermia can serve as predictor of outcome. Unlike previously reported associations in untreated asphyxiates, lactate levels had no relationship with outcome, which indicates that one of the working mechanisms of therapeutic hypothermia is reduction of the metabolic rate.
OBJECTIVE: The purpose of this study was to correlate brain metabolism assessed shortly after therapeutic hyperthermia by 1H magnetic resonance spectroscopy (MRS), with neurodevelopmental outcome. METHODS: At the age of 6.0±1.8days, brain metabolites of 35 term asphyxiated newborns, treated with therapeutic hypothermia, were quantified by multivoxel proton MRS of a volume cranial to the corpus callosum, containing both gray and white matter. At the age of 30months the Bayley Scale of Infant Development-III was performed. RESULTS:Infants that died had lower gray matter NAA levels than infants that survived (P=0.005). In surviving infants (28 of 35) there was a trend of negative correlation between gray matter choline levels and gross motor outcome (r=-0.45). In the white matter, choline correlated negatively with fine motor skills (r=-0.40), and creatine positively with gross motor skills (r=0.58, P=0.02). There was no relationship between lactate levels and outcome. CONCLUSION: MRS of asphyxiated neonates treated by therapeutic hypothermia can serve as predictor of outcome. Unlike previously reported associations in untreated asphyxiates, lactate levels had no relationship with outcome, which indicates that one of the working mechanisms of therapeutic hypothermia is reduction of the metabolic rate.
Authors: Jong Woo Lee; Lasya P Sreepada; Matthew B Bevers; Karen Li; Benjamin M Scirica; Danuzia Santana da Silva; Galen V Henderson; Camden Bay; Alexander P Lin Journal: Neurology Date: 2022-01-11 Impact factor: 9.910
Authors: Jessica L Wisnowski; Stefan Bluml; Ashok Panigrahy; Amit M Mathur; Jeffrey Berman; Ping-Sun Keven Chen; James Dix; Trevor Flynn; Stanley Fricke; Seth D Friedman; Hayden W Head; Chang Y Ho; Beth Kline-Fath; Michael Oveson; Richard Patterson; Sumit Pruthi; Nancy Rollins; Yanerys M Ramos; John Rampton; Jerome Rusin; Dennis W Shaw; Mark Smith; Jean Tkach; Shreyas Vasanawala; Arastoo Vossough; Matthew T Whitehead; Duan Xu; Kristen Yeom; Bryan Comstock; Patrick J Heagerty; Sandra E Juul; Yvonne W Wu; Robert C McKinstry Journal: BMJ Open Date: 2021-04-22 Impact factor: 2.692