Neonatal neurobehavioral abnormalities and MRI brain injury in encephalopathic newborns treated with hypothermia.
Neonatal neurobehavioral abnormalities and MRI brain injury in encephalopathic newborns treated with hypothermia.
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DOI：
10.1016/j.earlhumdev.2013.05.006
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发表时间：
2013-09
影响因子：
2.5
通讯作者：
Massaro, An N.
中科院分区：
文献类型：
--
作者：
Coleman, Maya B.;Glass, Penny;Brown, Judy;Kadom, Nadja;Tsuchida, Tammy;Scafidi, Joseph;Chang, Taeun;Vezina, Gilbert;Massaro, An N.
新生儿脑病（NE）是婴儿死亡和神经发育障碍的主要原因。亚低温是新生儿脑病的有效神经保护治疗方法。低温后新生儿神经行为异常与脑病新生儿MRI脑损伤结果之间的功能解剖学相关性先前尚未描述。目的探讨亚低温治疗新生儿脑病后神经行为异常与磁共振成像（MRI）脑损伤的关系。本观察性研究前瞻性纳入了接受低温治疗的新生儿缺氧缺血性脑病（HIE）。在目标年龄14天时使用NICU网络神经行为量表（NNNS）评估神经行为功能。在目标年龄7-10天时通过MRI评估脑损伤。比较了有和没有严重MRI损伤的婴儿之间的NNNS评分。68名患有中度至重度脑病的足月新生儿（62%为男性）在中位8天（范围5-16）时接受MRI检查，在中位12天（范围5-20）时接受NNNS检查。15例（22%）在MRI上有严重损伤。与没有严重MRI损伤的婴儿相比，婴儿的总体运动异常总评分和非最佳反射和不对称的个体汇总评分较高，而认知/行为领域的总NNNS Z评分较低（反映了较差的表现）（p<0.05）。NNNS确定的新生儿神经行为异常与低温后脑病新生儿的MRI脑损伤相关。NNNS可以提供新生儿结构性脑损伤的早期功能评估，这可能会指导围产期脑损伤后婴儿的康复治疗。
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. To evaluate the relationship between neonatal neurobehavioral abnormalities and brain injury on magnetic resonance imaging (MRI) in encephalopathic newborns treated with therapeutic hypothermia. 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. 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. Overall Total Motor Abnormality Score and individual summary scores for Nonoptimal Reflexes and Asymmetry were higher, while Total NNNS Z-score across cognitive/behavioral domains was lower (reflecting poorer performance) in infants with compared to those without severe MRI injury (p<0.05). 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.
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影响因子：
48
作者：
Rutherford, Mary;Ramenghi, Luca A.;Edwards, A. David;Brocklehurst, Peter;Halliday, Henry;Levene, Malcolm;Strohm, Brenda;Thoresen, Marianne;Whitelaw, Andrew;Azzopardi, Denis
通讯作者：
Azzopardi, Denis
影响因子：
5.1
作者：
Massaro, An N.;Chang, Taeun;Kadom, Nadja;Tsuchida, Tammy;Scafidi, Joseph;Glass, Penny;McCarter, Robert;Baumgart, Stephen;Vezina, Gilbert;Nelson, Karin B.
通讯作者：
Nelson, Karin B.
影响因子：
168.9
作者：
Gluckman, PD;Wyatt, JS;Gunn, AJ
通讯作者：
Gunn, AJ
影响因子：
5.1
作者：
Miller, SP;Ramaswamy, V;Ferriero, DM
通讯作者：
Ferriero, DM
影响因子：
2.5
作者：
SHANKARAN, S;WOLDT, E;NANDYAL, R
通讯作者：
NANDYAL, R