Gwendolyn J Gerner1,2,3, Eric I Newman4, V Joanna Burton2,5,6, Brenton Roman1, Elizabeth A Cristofalo2,7, Mary Leppert2,5, Michael V Johnston1,2,5,6,8, Frances J Northington2,9, Thierry A G M Huisman2,4, Andrea Poretti2,4,5. 1. 1 Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA. 2. 2 Neurosciences Intensive Care Nursery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. 3 Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. 4 Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. 5 Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA. 6. 6 Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. 7. 7 Frederick Memorial Hospital, Department of Neonatology, Frederick, MD, USA. 8. 8 Hugo Moser Research Institute, Kennedy Krieger Institute, Baltimore, MD, USA. 9. 9 Department of Perinatal-Neonatal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
AIM: Hypoxic-ischemic encephalopathy is associated with damage to deep gray matter; however, white matter involvement has become recognized. This study explored differences between patients and clinical controls on diffusion tensor imaging, and relationships between diffusion tensor imaging and neurodevelopmental outcomes. METHOD: Diffusion tensor imaging was obtained for 31 neonates after hypoxic-ischemic encephalopathy treated with therapeutic hypothermia and 10 clinical controls. A subgroup of patients with hypoxic-ischemic encephalopathy (n = 14) had neurodevelopmental outcomes correlated with diffusion tensor imaging scalars. RESULTS: Group differences in diffusion tensor imaging scalars were observed in the putamen, anterior and posterior centrum semiovale, and the splenium of the corpus callosum. Differences in these regions of interest were correlated with neurodevelopmental outcomes between ages 20 and 32 months. CONCLUSION: Therapeutic hypothermia may not be a complete intervention for hypoxic-ischemic encephalopathy, as neonatal white matter changes may continue to be evident, but further research is warranted. Patterns of white matter change on neonatal diffusion tensor imaging correlated with neurodevelopmental outcomes in this exploratory pilot study.
AIM: Hypoxic-ischemic encephalopathy is associated with damage to deep gray matter; however, white matter involvement has become recognized. This study explored differences between patients and clinical controls on diffusion tensor imaging, and relationships between diffusion tensor imaging and neurodevelopmental outcomes. METHOD: Diffusion tensor imaging was obtained for 31 neonates after hypoxic-ischemic encephalopathy treated with therapeutic hypothermia and 10 clinical controls. A subgroup of patients with hypoxic-ischemic encephalopathy (n = 14) had neurodevelopmental outcomes correlated with diffusion tensor imaging scalars. RESULTS: Group differences in diffusion tensor imaging scalars were observed in the putamen, anterior and posterior centrum semiovale, and the splenium of the corpus callosum. Differences in these regions of interest were correlated with neurodevelopmental outcomes between ages 20 and 32 months. CONCLUSION: Therapeutic hypothermia may not be a complete intervention for hypoxic-ischemic encephalopathy, as neonatal white matter changes may continue to be evident, but further research is warranted. Patterns of white matter change on neonatal diffusion tensor imaging correlated with neurodevelopmental outcomes in this exploratory pilot study.
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