{"title":"Elevated cerebral perfusion in neonatal encephalopathy is associated with neurodevelopmental impairments","authors":"Ruth O’Gorman Tuura, Raimund Kottke, Barbara Brotschi, Carola Sabandal, Cornelia Hagmann, Beatrice Latal","doi":"10.1038/s41390-024-03553-1","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Neonatal encephalopathy (NE) represents a primary cause of neonatal death and neurodevelopmental impairments. In newborns with NE, cerebral hyperperfusion is related to an increased risk of severe adverse outcomes, but less is known about the link between perfusion and mild to moderate developmental impairments or developmental delay.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Using arterial spin labelling perfusion MRI, we investigated the link between perfusion in 36 newborns with NE and developmental outcome at 2 years.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>53% of the infants demonstrated a normal outcome at 24 months, while two had cerebral palsy with impairments in cognitive, motor, and language domains, and three infants died. The remaining infants showed mild or moderate delays in development in one or two domains. Hyperperfusion across the whole brain was associated with more adverse outcome, including an increased risk of death or severe disability such as cerebral palsy. Among the surviving infants, higher perfusion in the bilateral basal ganglia, thalamus, hippocampus and cerebellum during the neonatal period was related to a poorer cognitive outcome at 2 years.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Hyperperfusion in infants with NE was associated with a more adverse outcome and lower cognitive outcome scores. In addition to severe adverse outcomes, altered perfusion is also related to mild to moderate impairment following HIE.</p><h3 data-test=\"abstract-sub-heading\">Impact statement</h3><ul>\n<li>\n<p>Neonates with neonatal encephalopathy (NE) show increased cerebral perfusion globally, which is linked to a more adverse outcome.</p>\n</li>\n<li>\n<p>Higher perfusion in the bilateral basal ganglia, thalamus, hippocampus and cerebellum during the neonatal period was related to a poorer cognitive outcome at 2 years.</p>\n</li>\n<li>\n<p>In addition to severe adverse outcomes altered perfusion is related to mild to moderate impairment following NE.</p>\n</li>\n<li>\n<p>To improve neurodevelopmental outcomes, it is important to improve our understanding of the factors influencing cerebral perfusion in infants with NE.</p>\n</li>\n</ul>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41390-024-03553-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Neonatal encephalopathy (NE) represents a primary cause of neonatal death and neurodevelopmental impairments. In newborns with NE, cerebral hyperperfusion is related to an increased risk of severe adverse outcomes, but less is known about the link between perfusion and mild to moderate developmental impairments or developmental delay.
Methods
Using arterial spin labelling perfusion MRI, we investigated the link between perfusion in 36 newborns with NE and developmental outcome at 2 years.
Results
53% of the infants demonstrated a normal outcome at 24 months, while two had cerebral palsy with impairments in cognitive, motor, and language domains, and three infants died. The remaining infants showed mild or moderate delays in development in one or two domains. Hyperperfusion across the whole brain was associated with more adverse outcome, including an increased risk of death or severe disability such as cerebral palsy. Among the surviving infants, higher perfusion in the bilateral basal ganglia, thalamus, hippocampus and cerebellum during the neonatal period was related to a poorer cognitive outcome at 2 years.
Conclusion
Hyperperfusion in infants with NE was associated with a more adverse outcome and lower cognitive outcome scores. In addition to severe adverse outcomes, altered perfusion is also related to mild to moderate impairment following HIE.
Impact statement
Neonates with neonatal encephalopathy (NE) show increased cerebral perfusion globally, which is linked to a more adverse outcome.
Higher perfusion in the bilateral basal ganglia, thalamus, hippocampus and cerebellum during the neonatal period was related to a poorer cognitive outcome at 2 years.
In addition to severe adverse outcomes altered perfusion is related to mild to moderate impairment following NE.
To improve neurodevelopmental outcomes, it is important to improve our understanding of the factors influencing cerebral perfusion in infants with NE.
背景新生儿脑病(NE)是导致新生儿死亡和神经发育障碍的主要原因。在患有 NE 的新生儿中,脑过度灌注与严重不良后果的风险增加有关,但灌注与轻度至中度发育障碍或发育迟缓之间的关系却鲜为人知。结果 53%的婴儿在24个月时表现正常,2名婴儿出现脑瘫,认知、运动和语言能力受损,3名婴儿死亡。其余婴儿在一个或两个领域出现轻度或中度发育迟缓。全脑高灌注与更多的不良后果有关,包括死亡或严重残疾(如脑瘫)的风险增加。在存活的婴儿中,新生儿期双侧基底节、丘脑、海马和小脑的高灌注与2岁时较差的认知结果有关。除了严重的不良预后外,灌注改变还与 HIE 后的轻度至中度损伤有关。影响声明患有新生儿脑病(NE)的新生儿会出现全身脑灌注增加,这与不良预后有关。新生儿期双侧基底节、丘脑、海马和小脑的脑灌注较高与2岁时较差的认知结果有关。为了改善神经发育结果,我们必须进一步了解影响NE婴儿脑灌注的因素。
期刊介绍:
Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and
disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques
relevant to developmental biology and medicine are acceptable, as are translational human studies