期刊
NEUROIMAGE-CLINICAL
卷 30, 期 -, 页码 -出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.nicl.2021.102582
关键词
Neonatal encephalopathy; Therapeutic hypothermia; White matter; Structural connectivity; Brain networks; Diffusion-weighted imaging
类别
资金
- Baily Thomas Charitable Fund [TRUST/VC/AC/SG4681-7596]
- David Telling Charitable Trust
- Moulton Foundation
- Wellcome Trust [WT220070/Z/20/Z]
- UK Medical Research Council [MR/N026969/1]
- EPSRC [EP/N014391/1]
- Wellcome Trust Institutional Strategic Support Award [WT105618MA]
- Sparks [05/BTL/01, 14/BTL/01]
- MRC [MR/N026969/1] Funding Source: UKRI
Therapeutic hypothermia for neonatal encephalopathy following birth asphyxia reduces death and cerebral palsy risks, but school-age children treated with this method still show cognitive and motor deficits compared to controls. Diffusion-weighted imaging revealed widespread changes in white matter structure in these children. Network-based statistic analysis identified brain regions associated with visuo-spatial processing and attention as being affected.
Therapeutic hypothermia following neonatal encephalopathy due to birth asphyxia reduces death and cerebral palsy. However, school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal encephalopathy still have reduced performance on cognitive and motor tests, attention difficulties, slower reaction times and reduced visuo-spatial processing abilities compared to typically developing controls. We acquired diffusion-weighted imaging data from school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal encephalopathy at birth, and a matched control group. Voxelwise analysis (33 cases, 36 controls) confirmed reduced fractional anisotropy in widespread areas of white matter in cases, particularly in the fornix, corpus callosum, anterior and posterior limbs of the internal capsule bilaterally and cingulum bilaterally. In structural brain networks constructed using probabilistic tractography (22 cases, 32 controls), graph-theoretic measures of strength, local and global efficiency, clustering coefficient and characteristic path length were found to correlate with IQ in cases but not controls. Network-based statistic analysis implicated brain regions involved in visuo-spatial processing and attention, aligning with previous behavioural findings. These included the precuneus, thalamus, left superior parietal gyrus and left inferior temporal gyrus. Our findings demonstrate that, despite the manifest successes of therapeutic hypothermia, brain development is impaired in these children.
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