Document Type
Journal Article
Publication Date
9-2013
Journal
Early Human Development
Volume
Volume 89, Issue 9
Inclusive Pages
733-737
Keywords
Brain Injuries--diagnosis; Developmental Disabilities--diagnosis; Hypothermia, Induced; Magnetic Resonance Imaging
Abstract
Background
Neonatal Encephalopathy (NE) is a prominent cause of infant mortality and neurodevelopmental disability. Hypothermia is an effective neuroprotective therapy for newborns with encephalopathy. Post-hypothermia functional–anatomical correlation between neonatal neurobehavioral abnormalities and brain injury findings on MRI in encephalopathic newborns has not been previously described.
Aim
To evaluate the relationship between neonatal neurobehavioral abnormalities and brain injury on magnetic resonance imaging (MRI) in encephalopathic newborns treated with therapeutic hypothermia.
Study design
Neonates with hypoxic ischemic encephalopathy (HIE) referred for therapeutic hypothermia were prospectively enrolled in this observational study. Neurobehavioral functioning was assessed with the NICU network neurobehavioral scale (NNNS) performed at target age 14 days. Brain injury was assessed by MRI at target age 7–10 days. NNNS scores were compared between infants with and without severe MRI injury.
Subjects & outcome measures
Sixty-eight term newborns (62% males) with moderate to severe encephalopathy underwent MRI at median 8 days (range 5–16) and NNNS at median 12 days of life (range 5–20). Fifteen (22%) had severe injury on MRI.
Results
Overall Total Motor Abnormality Score and individual summary scores for Non-optimal Reflexes and Asymmetry were higher, while Total NNNS Z-score across cognitive/behavioral domains was lower (reflecting poorer performance) in infants with severe MRI injury compared to those without (p < 0.05).
Conclusions
Neonatal neurobehavioral abnormalities identified by the NNNS are associated with MRI brain injury in encephalopathic newborns post-hypothermia. The NNNS can provide an early functional assessment of structural brain injury in newborns, which may guide rehabilitative therapies in infants after perinatal brain injury.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
APA Citation
Coleman, M.B., Glass, P., Brown, J., Kadom, N., Tsuchida, T., Scafidi, J., Chang, T., Vezina, G., Massaro, A.N. (2013). Neonatal neurobehavioral abnormalities and MRI brain injury in encephalopathic newborns treated with hypothermia. Early Human Development, 89(9), 733-737.
Peer Reviewed
1
Open Access
1
Comments
Reproduced with permission of Elsevier Early Human Development.