Narjess Boutalbi, Samuel Dahan, William Rozalen, Thibault Beretti, Laurene Fortis, Lucie Delefosse, Robin Cloarec, Benoit Testud, Virginie Fouilloux, Célia Gran, Giulia Danielou, Florent Paoli, Fedoua El-Louali, Julie Blanc, Camille Velly, Guillaume Carles, Chloe Wanert, Sophie Quennelle, Stéphane Lebel, Solène Denantes, Pierre Bourgoin, Matthieu Laborier, Sophie Arnaud, Dominique Santelli, Edouard Aries, Chloé Allary, Isabelle Grandvuillemin, Clotilde Desrobert, Johanna Calderon, Farid Boubred, Fabrice Michel, Caroline Ovaert, Mathieu Milh, Marien Lenoir, Béatrice Desnous
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Identifying early biomarkers of motor function could capture a critical window for intervention. We assessed the prognostic value of neuron-specific enolase (NSE) and S100B in predicting 4-month motor outcomes in newborns undergoing cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>Between December 2021 and October 2024, we conducted a prospective, single-centre study including term neonates with (CCHD) who required cardiac surgery within the first two months of life. NSE and S100B levels were measured at five perioperative time points. Blinded Alberta Infant Motor Scale (AIMS) assessment at four months evaluated motor outcomes.</p><p><strong>Results: </strong>Of 35 newborns, 27 completed follow-up. Preoperative NSE levels were significantly higher in infants with AIMS scores below the 10th percentile (32.7 vs. 20.9 ng/mL, p = 0.044) and negatively correlated with AIMS percentiles (ρ = -0.617, p = 0.006. 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引用次数: 0
摘要
背景：患有复杂先天性心脏病（CCHD）的儿童在所有领域都有早期神经发育迟缓的高风险。神经运动延迟通常首先出现，并可能影响更广泛的发展。识别运动功能的早期生物标志物可以抓住干预的关键窗口。我们评估了神经元特异性烯醇化酶（NSE）和S100B在预测心脏手术合并体外循环（CPB）新生儿4个月运动预后方面的预后价值。方法：在2021年12月至2024年10月期间，我们进行了一项前瞻性单中心研究，包括在出生后两个月内需要心脏手术的足月新生儿（CCHD）。测定围手术期5个时间点的NSE和S100B水平。盲法阿尔伯塔省婴儿运动量表（AIMS）在四个月时评估运动结果。结果：35例新生儿中，27例完成随访。AIMS评分低于第10百分位数的婴儿术前NSE水平显著升高（32.7比20.9 ng/mL, p = 0.044），且与AIMS百分位数呈负相关（ρ = -0.617, p = 0.006）。运动结果、MRI结果或S100B水平之间无显著关联。结论：术前较高的NSE水平预示着CCHD早期运动预后较差，可能是早期风险分层和干预的标志。影响：神经元特异性烯醇化酶（NSE）可作为新生儿复杂先天性心脏病（CCHD）神经运动发育的早期生物标志物。术前NSE水平升高与4个月时较差的运动预后相关。NSE可以作为多模式风险分层策略中的额外生物标志物，补充临床、成像和电生理评估，以完善预后评估。这些发现强调围手术期生物标志物在预测早期运动预后和支持早期识别高危新生儿方面的预后价值，从而实现有针对性的神经发育干预。这项工作为有限的关于新生儿心脏手术后运动发育的生物学预测因素的文献提供了新的证据。
Early motor outcomes in infants with complex congenital heart disease: the predictive role of NSE and S100B.
Background: Children with complex congenital heart disease (CCHD) are at high risk for early neurodevelopmental delays across all domains. Neuromotor delay often emerges first and may impact broader development. Identifying early biomarkers of motor function could capture a critical window for intervention. We assessed the prognostic value of neuron-specific enolase (NSE) and S100B in predicting 4-month motor outcomes in newborns undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Methods: Between December 2021 and October 2024, we conducted a prospective, single-centre study including term neonates with (CCHD) who required cardiac surgery within the first two months of life. NSE and S100B levels were measured at five perioperative time points. Blinded Alberta Infant Motor Scale (AIMS) assessment at four months evaluated motor outcomes.
Results: Of 35 newborns, 27 completed follow-up. Preoperative NSE levels were significantly higher in infants with AIMS scores below the 10th percentile (32.7 vs. 20.9 ng/mL, p = 0.044) and negatively correlated with AIMS percentiles (ρ = -0.617, p = 0.006. There was no significant association between motor outcomes, MRI findings or S100B levels.
Conclusions: Higher preoperative NSE levels predict poor early motor outcomes in CCHD and may be a marker for early risk stratification and intervention.
Impact: Neuron-specific enolase (NSE) may serve as an early biomarker of neuromotor development in newborns with complex congenital heart disease (CCHD). Elevated preoperative NSE levels were associated with poorer motor outcomes at four months. NSE may serve as an additional biomarker within a multimodal risk stratification strategy, complementing clinical, imaging, and electrophysiological assessments to refine prognostic evaluation. These findings highlight the prognostic value of perioperative biomarkers for predicting early motor outcomes and support earlier identification of at-risk newborns, enabling targeted neurodevelopmental interventions. This work adds new evidence to limited literature on biological predictors of motor development after neonatal cardiac surgery.
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
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