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.
journal_name
Early Hum Devjournal_title
Early human developmentauthors
Coleman MB,Glass P,Brown J,Kadom N,Tsuchida T,Scafidi J,Chang T,Vezina G,Massaro ANdoi
10.1016/j.earlhumdev.2013.05.006subject
Has Abstractpub_date
2013-09-01 00:00:00pages
733-7issue
9eissn
0378-3782issn
1872-6232pii
S0378-3782(13)00127-8journal_volume
89pub_type
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