Agnese Suppiej1, Ambra Cappellari2, Giacomo Talenti3, Elisa Cainelli2, Matteo Di Capua4, Augusta Janes5, Daniela Longo6, Rodica Mardari3, Cristina Marinaccio7, Stefano Pro4, Paola Sciortino8, Daniele Trevisanuto9, Roberta Vittorini7, Renzo Manara10. 1. Child Neurology and Clinical Neurophysiology, Pediatric University Hospital of Padova, Italy. Electronic address: agnese.suppiej@unipd.it. 2. Child Neurology and Clinical Neurophysiology, Pediatric University Hospital of Padova, Italy. 3. Neuroradiology Unit, University Hospital of Padova, Italy. 4. Neurophysiology Unit, Department of Neuroscience, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy. 5. Terapia Intensiva Neonatale Azienda Sanitaria Unica Integrata SMM Udine, Italy. 6. Neuroradiology Unit, Ospedale Pediatrico Bambino Gesù - IRCCS - Roma, Italy. 7. SC Neuropsichiatria Infantile Dipartimento di Pediatria e Specialità Pediatriche, A.O.U. Città della Salute e della Scienza Torino, Presidio OIRM, Italy. 8. SC Neuroradiologia, Dipartimento di Diagnostica per Immagini e Radioterapia, A.O.U. Città della Salute e della Scienza Torino, Presidio CTO, Italy. 9. Neonatal Intensive Care Unit, Pediatric University Hospital of Padova, Italy. 10. Neuroradiology, University of Salerno, Italy.
Abstract
OBJECTIVE: The introduction of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs). METHODS: Among 80 consecutive neonates undergoing hypothermia for hypoxic-ischemic encephalopathy, 58 performed SEPs and MRI at 4-14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20). The severity of brain injury was scored using MRI. RESULTS: Bilaterally absent N20 was observed in 10/58 neonates (17%); all had moderate/severe MRI abnormalities; 36/48 neonates (75%) with score 0 at SEPs had normal MRI. The positive predictive value of SEPs on MRI outcome was of 1.00, while the negative predictive value 0.72, sensitivity 0.48, specificity 1.00, with an accuracy of 0.78 (p < .001). CONCLUSIONS: Bilateral absence of cortical SEPs predicts moderate/severe MRI pattern of injury. SIGNIFICANCE: Therapeutic hypothermia does not seem to significantly affect prognostic reliability of SEPs.
OBJECTIVE: The introduction of therapeutic hypothermia for neonatal hypoxic-ischemicencephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs). METHODS: Among 80 consecutive neonates undergoing hypothermia for hypoxic-ischemicencephalopathy, 58 performed SEPs and MRI at 4-14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20). The severity of brain injury was scored using MRI. RESULTS: Bilaterally absent N20 was observed in 10/58 neonates (17%); all had moderate/severe MRI abnormalities; 36/48 neonates (75%) with score 0 at SEPs had normal MRI. The positive predictive value of SEPs on MRI outcome was of 1.00, while the negative predictive value 0.72, sensitivity 0.48, specificity 1.00, with an accuracy of 0.78 (p < .001). CONCLUSIONS: Bilateral absence of cortical SEPs predicts moderate/severe MRI pattern of injury. SIGNIFICANCE: Therapeutic hypothermia does not seem to significantly affect prognostic reliability of SEPs.
Authors: Daphne Kamino; Asma Almazrooei; Elizabeth W Pang; Elysa Widjaja; Aideen M Moore; Vann Chau; Emily W Y Tam Journal: Clin Neurophysiol Date: 2020-10-22 Impact factor: 3.708