Motor performance and higher associative cortical networks in adolescents with neonatal hypoxic-ischaemic encephalopathy treated with therapeutic hypothermia.

Abstract

Aim: To investigate the interaction between specialized motor networks and higher associative brain networks for motor performance in adolescents exposed to neonatal hypoxic-ischaemic encephalopathy (HIE).

Method: In this prospective, population-based cohort study of children (n = 66) with neonatal HIE treated with therapeutic hypothermia, follow-up was performed at age 10 to 12 years with resting-state functional magnetic resonance imaging and assessment of motor performance with the Movement Assessment Battery for Children, Second Edition (MABC-2). Brain-behaviour analysis was performed using statistical enrichment analysis and was compared to a control group (n = 43) using the McNemar test.

Results: The final analysis included 35 children in the cohort with HIE (mean [SD] age at magnetic resonance imaging = 11 years 2 months [9 months]) and 21 children in the control cohort (10 years 2 months [8 months]). Motor performance (assessed with the MABC-2 total score and all subdomains) was reduced in the cohort with HIE compared to the controls and was significantly associated with several clusters of brain network connections. A significant group difference was found in the MABC-2 aiming and catching subdomain, which correlated with clusters of functional connectivity between the somatomotor and default mode networks in the cohort with HIE.

Interpretation: Motor impairment after therapeutic hypothermia-treated neonatal HIE is connected to alternative neural processing between motor and cognitive networks.