M Molavi1, S D Vann2, L S de Vries1, F Groenendaal1, M Lequin3. 1. From the Departments of Radiology and Neonatology (M.M., L.S.d.V., F.G., M.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands. 2. School of Psychology (S.D.V.), Cardiff University, Cardiff, UK. 3. From the Departments of Radiology and Neonatology (M.M., L.S.d.V., F.G., M.L.), Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands M.H.Lequin@umcutrecht.nl.
Abstract
BACKGROUND AND PURPOSE: Research into memory deficits associated with hypoxic-ischemic encephalopathy has typically focused on the hippocampus, but there is emerging evidence that the medial diencephalon may also be compromised. We hypothesized that mammillary body damage occurs in perinatal asphyxia, potentially resulting in mammillary body atrophy and subsequent memory impairment. MATERIALS AND METHODS: We retrospectively reviewed brain MRIs of 235 clinically confirmed full-term patients with hypoxic-ischemic encephalopathy acquired at a single center during 2004-2017. MRIs were performed within 10 days of birth (median, 6; interquartile range, 2). Two radiologists independently assessed the mammillary bodies for abnormal signal on T2-weighted and DWI sequences. Follow-up MRIs were available for 9 patients; these were examined for evidence of mammillary body and hippocampal atrophy. RESULTS: In 31 neonates (13.2%), abnormal high mammillary body signal was seen on T2-weighted sequences, 4 with mild, 25 with moderate, and 2 with severe hypoxic-ischemic encephalopathy. In addition, restricted diffusion was seen in 6 neonates who had MR imaging between days 5 and 7. For these 31 neonates, the most common MR imaging pattern (41.9%) was abnormal signal restricted to the mammillary bodies with the rest of the brain appearing normal. Follow-up MRIs were available for 9 patients: 8 acquired between 3 and 19 months and 1 acquired at 7.5 years. There was mammillary body atrophy in 8 of the 9 follow-up MRIs. CONCLUSIONS: Approximately 13% of full-term infants with hypoxic-ischemic encephalopathy showed abnormal high mammillary body signal on T2-weighted images during the acute phase, which progressed to mammillary body atrophy in all but 1 of the infants who had follow-up MR imaging. This mammillary body involvement does not appear to be related to the severity of encephalopathy, MR imaging patterns of hypoxic-ischemic encephalopathy, or pathology elsewhere in the brain.
BACKGROUND AND PURPOSE: Research into memory deficits associated with hypoxic-ischemic encephalopathy has typically focused on the hippocampus, but there is emerging evidence that the medial diencephalon may also be compromised. We hypothesized that mammillary body damage occurs in perinatal asphyxia, potentially resulting in mammillary body atrophy and subsequent memory impairment. MATERIALS AND METHODS: We retrospectively reviewed brain MRIs of 235 clinically confirmed full-term patients with hypoxic-ischemic encephalopathy acquired at a single center during 2004-2017. MRIs were performed within 10 days of birth (median, 6; interquartile range, 2). Two radiologists independently assessed the mammillary bodies for abnormal signal on T2-weighted and DWI sequences. Follow-up MRIs were available for 9 patients; these were examined for evidence of mammillary body and hippocampal atrophy. RESULTS: In 31 neonates (13.2%), abnormal high mammillary body signal was seen on T2-weighted sequences, 4 with mild, 25 with moderate, and 2 with severe hypoxic-ischemic encephalopathy. In addition, restricted diffusion was seen in 6 neonates who had MR imaging between days 5 and 7. For these 31 neonates, the most common MR imaging pattern (41.9%) was abnormal signal restricted to the mammillary bodies with the rest of the brain appearing normal. Follow-up MRIs were available for 9 patients: 8 acquired between 3 and 19 months and 1 acquired at 7.5 years. There was mammillary body atrophy in 8 of the 9 follow-up MRIs. CONCLUSIONS: Approximately 13% of full-term infants with hypoxic-ischemic encephalopathy showed abnormal high mammillary body signal on T2-weighted images during the acute phase, which progressed to mammillary body atrophy in all but 1 of the infants who had follow-up MR imaging. This mammillary body involvement does not appear to be related to the severity of encephalopathy, MR imaging patterns of hypoxic-ischemic encephalopathy, or pathology elsewhere in the brain.
Authors: Frances Cowan; Mary Rutherford; Floris Groenendaal; Paula Eken; Eugenio Mercuri; Graeme M Bydder; Linda C Meiners; Lilly M S Dubowitz; Linda S de Vries Journal: Lancet Date: 2003-03-01 Impact factor: 79.321
Authors: Thomas Alderliesten; Linda S de Vries; Manon J N L Benders; Corine Koopman; Floris Groenendaal Journal: Radiology Date: 2011-08-09 Impact factor: 11.105
Authors: Rajesh Kumar; Mary A Woo; Bramley V X Birrer; Paul M Macey; Gregg C Fonarow; Michele A Hamilton; Ronald M Harper Journal: Neurobiol Dis Date: 2008-10-31 Impact factor: 5.996
Authors: Lauren C Weeke; Floris Groenendaal; Kalyani Mudigonda; Mats Blennow; Maarten H Lequin; Linda C Meiners; Ingrid C van Haastert; Manon J Benders; Boubou Hallberg; Linda S de Vries Journal: J Pediatr Date: 2018-01 Impact factor: 4.406
Authors: Rajesh Kumar; Bramley V X Birrer; Paul M Macey; Mary A Woo; Rakesh K Gupta; Frisca L Yan-Go; Ronald M Harper Journal: Neurosci Lett Date: 2008-04-25 Impact factor: 3.046
Authors: Christopher M Dillingham; Michal M Milczarek; James C Perry; Seralynne D Vann Journal: Neurosci Biobehav Rev Date: 2020-12-09 Impact factor: 8.989
Authors: Kim V Annink; Linda S de Vries; Floris Groenendaal; Rian M J C Eijsermans; Manouk Mocking; Monique M J van Schooneveld; Jeroen Dudink; Henrica L M van Straaten; Manon J N L Benders; Maarten Lequin; Niek E van der Aa Journal: Sci Rep Date: 2021-03-03 Impact factor: 4.379
Authors: Sharon Geva; Sebastian Jentschke; Georgios P D Argyropoulos; W K Chong; David G Gadian; Faraneh Vargha-Khadem Journal: Neuroimage Clin Date: 2020-09-15 Impact factor: 4.881
Authors: Gian Pietro Sechi; Flaminia Bardanzellu; Maria Cristina Pintus; Maria Margherita Sechi; Maria Antonietta Marcialis; Vassilios Fanos Journal: Antioxidants (Basel) Date: 2021-12-25
Authors: Maarten H Lequin; Sylke J Steggerda; Mariasavina Severino; Domenico Tortora; Alessandro Parodi; Luca A Ramenghi; Floris Groenendaal; Karlijn M E Meys; Manon J N L Benders; Linda S de Vries; Seralynne D Vann Journal: Pediatr Res Date: 2021-03-02 Impact factor: 3.953