Abstract
Objective:
To relate volumetric magnetic resonance imaging (MRI) findings to hypothermia therapy and neurosensory impairments.
Study Design:
Newborns ⩾36 weeks’ gestation with hypoxic–ischemic encephalopathy who participated in the National Institute of Child Health and Human Development hypothermia randomized trial at our center were eligible. We determined the relationship between hypothermia treatment and usual care (control) to absolute and relative cerebral tissue volumes. Furthermore, we correlated brain volumes with death or neurosensory impairments at 18 to 22 months.
Result:
Both treatment groups were comparable before randomization. Total brain tissue volumes did not differ in relation to treatment assignment. However, relative volumes of subcortical white matter were significantly larger in hypothermia-treated than control infants. Furthermore, relative total brain volumes correlated significantly with death or neurosensory impairments. Relative volumes of the cortical gray and subcortical white matter also correlated significantly with Bayley Scales psychomotor development index.
Conclusion:
Selected volumetric MRI findings correlated with hypothermia therapy and neurosensory impairments. Larger studies using MRI brain volumes as a secondary outcome measure are needed.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Hull J, Dodd KL . Falling incidence of hypoxic–ischaemic encephalopathy in term infants. Br J Obstet Gynaecol 1992; 99 (5): 386–391.
Thornberg E, Thiringer K, Odeback A, Milsom I . Birth asphyxia: incidence, clinical course and outcome in a Swedish population. Acta Paediatr 1995; 84 (8): 927–932.
Smith J, Wells L, Dodd K . The continuing fall in incidence of hypoxic–ischaemic encephalopathy in term infants. BJOG 2000; 107 (4): 461–466.
Robertson CMT, Finer NN, Grace MGA . School performance of survivors of neonatal encephalopathy associated with birth asphyxia at term. J Pediatr 1989; 114: 753–760.
Gunn AJ, Gluckman PD, Gunn TR . Selective head cooling in newborn infants after perinatal asphyxia: a safety study. Pediatrics 1998; 102: 885–892.
Eicher DJ, Wagner CL, Katikaneni LP, Hulsey TC, Bass WT, Kaufman DA et al. Moderate hypothermia in neonatal encephalopathy: efficacy outcomes. Pediatr Neurol 2005; 32 (1): 11–17.
Gluckman PD, Wyatt JS, Azopardi D, Ballard R, Edwards AD, Ferriero DM et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomized trial. Lancet 2005; 365: 663–670.
Shankaran S, Laptook A, Wright LL, Ehrenkranz RA, Donovan EF, Fanaroff AA et al. Whole-body hypothermia for neonatal encephalopathy: animal observations as a basis for a randomized, controlled pilot study in term infants. Pediatrics 2002; 110 (2 Part 1): 377–385.
Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, et al., National Institute of Child Health and Human Development Neonatal Research Network. Whole-body hypothermia for neonates with hypoxic–ischemic encephalopathy. N Engl J Med 2005; 353: 1574–1584.
Shao X, Zhou W, Cheng G . Head cooling in neonatal hypoxic–ischemic encephalopathy-multicenter randomized trial from China. Presented at Hot Topics in Neonatology 2005,. Washington, DC.
Laptook AR, Corbett RJ . The effects of temperature on hypoxic–ischemic brain injury. Clin Perinatol 2002; 29: 623–649.
Safar PJ, Kochanek PM . Therapeutic hypothermia after cardiac arrest. N Engl J Med 2002; 346 (8): 612–613.
Inder TE, Hunt RW, Morley CJ, Coleman L, Stewart M, Doyle LW et al. Randomized trial of systemic hypothermia selectively protects the cortex on MRI in term hypoxic–ischemic encephalopathy. J Pediatr 2004; 145 (6): 835–837.
Rutherford MA, Azzopardi D, Whitelaw A, Cowan F, Renowden S, Edwards AD et al. Mild hypothermia and the distribution of cerebral lesions in neonates with hypoxic–ischemic encephalopathy. Pediatrics 2005; 116 (4): 1001–1006.
Belet N, Belet U, Incesu L, Uysal S, Ozinal S, Keskin T et al. Hypoxic–ischemic encephalopathy: correlation of serial MRI and outcome. Pediatr Neurol 2004; 31: 267–274.
Ment LR, Bada HS, Barnes P, Grant PE, Hirtz D, Papile LA et al. Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2002; 58: 1726–1738.
Parikh NA, Lasky RE, Kennedy KA, Moya FR, Hochhauser L, Romo S et al. Postnatal dexamethasone therapy and cerebral tissue volumes in extremely low birth weight infants. Pediatrics 2007; 119 (2): 265–272.
Sie LT, van der Knaap MS, Oosting J, de Vries LS, Lafeber HN, Valk J . MR patterns of hypoxic–ischemic brain damage after prenatal, perinatal or postnatal asphyxia. Neuropediatrics 2000; 31: 128–136.
Inder TE, Warfield SK, Wang H, Huppi PS, Volpe JJ . Abnormal cerebral structure is present at term in premature infants. Pediatrics 2005; 115 (2): 286–294.
Peterson BS, Anderson AW, Ehrenkranz R, Staib LH, Tageldin M, Colson E et al. Regional brain volumes and their later neurodevelopmental correlates in term and preterm infants. Pediatrics 2003; 111: 939–948.
Barkovich AJ, Hajnal BL, Vigneron D, Sola A, Partridge JC, Allen F et al. Prediction of neuromotor outcome in perinatal asphyxia: evaluation of MR scoring systems. AJNR Am J Neuroradiol 1998; 19 (1): 143–149.
Mercuri E, Rutherford M, Barnett A, Foglia C, Haataja L, Counsell S et al. MRI lesions and infants with neonatal encephalopathy. Is the Apgar score predictive? Neuropediatrics 2002; 33 (3): 150–156.
Rutherford MA, Pennock JM, Counsell SJ, Mercuri E, Cowan FM, Dubowitz LM et al. Abnormal magnetic resonance signal in the internal capsule predicts poor neurodevelopmental outcome in infants with hypoxic–ischemic encephalopathy. Pediatrics 1998; 102: 323–328.
Haines DE . Neuroanatomy: An Atlas of Structures, Sections and Systems, 3rd edn. Williams & Wilkins: Baltimore, MD, 1991.
Bayer SA, Altman J . The Human Brain During the Third Trimester (Atlas of Human Central Nervous System Development). CRC Press: Boca Raton, FL., 2003.
University of Michigan. The Navigable Atlas of the Human Brain. Available at: http://www.msu.edu/~brains/brains/human/index.html Accessed August 14, 2007.
Interactive Atlases. Digital Anatomist: Interactive Brain Atlas. University of Washington. Available at: http://www9.biostr.washington.edu/da.html Accessed August 14, 2007.
Honeycutt NA, Smith PD, Aylward E, Li Q, Chan M, Barta PE . Mesial temporal lobe measurements on magnetic resonance imaging scans. Psychiatry Res 1998; 83 (2): 85–94.
Hastings RS, Parsey RV, Oquendo MA, Arango V, Mann JJ . Volumetric analysis of the prefrontal cortex, amygdala, and hippocampus in major depression. Neuropsychopharmacology 2004; 29: 952–959.
Gur RE, Maany V, Mozley PD, Swanson C, Bilker W, Gur RC . Subcortical MRI volumes in neuroleptic-naive and treated patients with schizophrenia. Am J Psychiatry 1998; 155 (12): 1711–1717.
Postle BR, D′Esposito M . Spatial working memory activity of the caudate nucleus is sensitive to frame of reference. Cogn Affect Behav Neurosci 2003; 3: 133–144.
Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B . Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997; 39 (4): 214–223.
Bayley N . Bayley Scales of Infant Development-II. Psychological Corporation: San Antonio, TX, 1993.
Rothman KJ, Greenland S . Modern Epidemiology, 2nd edn. Lippincott-Raven: Philadelphia, PA, 1998.
Gluckman PD, Pinal CS, Gunn AJ . Hypoxic–ischemic brain injury in the newborn: pathophysiology and potential strategies for intervention. Semin Neonatol 2001; 6: 109–120.
Woodward LJ, Edgin JO, Thompson D, Inder TE . Object working memory deficits predicted by early brain injury and development in the preterm infant. Brain 2005; 128: 2578–2587.
Acknowledgements
This work was supported in part by National Institutes of Health Grant 5K23NS048152 to Nehal Parikh. We thank the NICHD Neonatal Research Network for access to hypothermia study data.
Author information
Authors and Affiliations
Corresponding author
Additional information
Conflict of interest
The authors have no conflicts of interest to disclose.
Rights and permissions
About this article
Cite this article
Parikh, N., Lasky, R., Garza, C. et al. Volumetric and anatomical MRI for hypoxic–ischemic encephalopathy: relationship to hypothermia therapy and neurosensory impairments. J Perinatol 29, 143–149 (2009). https://doi.org/10.1038/jp.2008.184
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2008.184
Keywords
This article is cited by
-
Subcortical brain volumes in neonatal hypoxic–ischemic encephalopathy
Pediatric Research (2023)
-
Physiologic and pharmacologic considerations for hypothermia therapy in neonates
Journal of Perinatology (2011)
-
Quantitative analysis of magnetic resonance images and neurological outcome in encephalopathic neonates treated with whole-body hypothermia
Journal of Perinatology (2010)