Magnetic resonance spectroscopy assessment of brain injury after moderate hypothermia in neonatal encephalopathy: a prospective multicentre cohort study

Publication date: Available online 15 November 2018Source: The Lancet NeurologyAuthor(s): Peter J Lally, Paolo Montaldo, Vânia Oliveira, Aung Soe, Ravi Swamy, Paul Bassett, Josephine Mendoza, Gaurav Atreja, Ujwal Kariholu, Santosh Pattnayak, Palaniappan Sashikumar, Helen Harizaj, Martin Mitchell, Vijayakumar Ganesh, Sundeep Harigopal, Jennifer Dixon, Philip English, Paul Clarke, Priya Muthukumar, Prakash SatodiaSummaryBackgroundIn neonatal encephalopathy, the clinical manifestations of injury can only be reliably assessed several years after an intervention, complicating early prognostication and rendering trials of promising neuroprotectants slow and expensive. We aimed to determine the accuracy of thalamic proton magnetic resonance (MR) spectroscopy (MRS) biomarkers as early predictors of the neurodevelopmental abnormalities observed years after neonatal encephalopathy.MethodsWe did a prospective multicentre cohort study across eight neonatal intensive care units in the UK and USA, recruiting term and near-term neonates who received therapeutic hypothermia for neonatal encephalopathy. We excluded infants with life-threatening congenital malformations, syndromic disorders, neurometabolic diseases, or any alternative diagnoses for encephalopathy that were apparent within 6 h of birth. We obtained T1-weighted, T2-weighted, and diffusion-weighted MRI and thalamic proton MRS 4–14 days after birth. Clinical neurodevelopmental tests were done 18–24 months later. The primary o...
Source: The Lancet Neurology - Category: Neurology Source Type: research