Early Post-cooling Brain Magnetic Resonance for the Prediction of Neurodevelopmental Outcome in Newborns with Hypoxic-Ischemic Encephalopathy

Mario Mastrangelo; Giulia Di Marzo; Flavia Chiarotti; Chiara Andreoli; Maria Chiara Colajacomo; Anna Ruggieri; Paola Papoff

doi:10.4103/jpn.JPN_25_19

Early Post-cooling Brain Magnetic Resonance for the Prediction of Neurodevelopmental Outcome in Newborns with Hypoxic-Ischemic Encephalopathy

J Pediatr Neurosci. 2019 Oct-Dec;14(4):191-202. doi: 10.4103/jpn.JPN_25_19. Epub 2019 Dec 3.

Authors

Mario Mastrangelo¹, Giulia Di Marzo², Flavia Chiarotti³, Chiara Andreoli⁴, Maria Chiara Colajacomo⁴, Anna Ruggieri², Paola Papoff²

Affiliations

¹ Division of Pediatric Neurology, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
² Pediatric Intensive Care Unit, Department of Pediatrics, Child Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
³ Department of Cell Biology and Neuroscience, National Institute of Health, Rome, Italy.
⁴ Emergency Radiology Unit, Department of Emergency and Acceptance, Sapienza University of Rome, Rome, Italy.

Abstract

Aim and objectives: This study aimed to evaluate the predictive role of early post-cooling brain magnetic resonance for developmental outcome in newborns with hypoxic-ischemic encephalopathy.

Materials and methods: A retrospective cohort study was performed on 29 consecutive patients through magnetic resonance evaluation (visual analysis of the images and scoring of the detected lesions; mean diffusivity of semioval centre and lenticular nuclei; and area under the curve of basal ganglia N-acetylaspartate at proton magnetic resonance spectroscopic imaging) and Griffiths Mental Development Scales-third edition at 12 and 24 months.

Results: Brain magnetic resonance was performed at a mean age of 5.7 ± 3.7 days. Newborns with no/minor magnetic resonance abnormalities had a better developmental outcome than patients with moderate or severe lesions. Structural and spectroscopic abnormalities in basal ganglia resulted in the most significant predictors for an unfavorable outcome.

Conclusion: Normal magnetic resonance in early post-cooling phases is strongly associated with a favorable developmental outcome.

Keywords: Development; hypoxic–ischemic encephalopathy; magnetic resonance; newborns; therapeutic hypothermia.