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01-06-2019 | Encephalopathy | Original Article

Early proton magnetic resonance spectroscopy during and after therapeutic hypothermia in perinatal hypoxic–ischemic encephalopathy

Authors: Ashley M. Lucke, Anil N. Shetty, Joseph L. Hagan, Allison Walton, Tiffany D. Stafford, Zili D. Chu, Christopher J. Rhee, Jeffrey R. Kaiser, Magdalena Sanz Cortes

Published in: Pediatric Radiology | Issue 7/2019

Abstract

Background

Hypoxic–ischemic encephalopathy (HIE) remains a significant cause of mortality and neurodevelopmental impairment despite treatment with therapeutic hypothermia. Magnetic resonance H¹-spectroscopy measures concentrations of cerebral metabolites to detect derangements in aerobic metabolism.

Objective

We assessed MR spectroscopy in neonates with HIE within 18–24 h of initiating therapeutic hypothermia and at 5–6 days post therapeutic hypothermia.

Materials and methods

Eleven neonates with HIE underwent MR spectroscopy of the basal ganglia and white matter. We compared metabolite concentrations during therapeutic hypothermia and post-therapeutic hypothermia and between moderate and severe HIE.

Results

During therapeutic hypothermia, neonates with severe HIE had decreased basal ganglia N-acetylaspartate (NAA; 0.62±0.08 vs. 0.72±0.05; P=0.02), NAA + N-acetylaspartylglutamate (NAAG; 0.66±0.11 vs. 0.77±0.06; P=0.05), glycerophosphorylcholine + phosphatidylcholine (GPC+PCh; 0.28±0.05 vs. 0.38±0.06; P=0.02) and decreased white matter GPC+PCh (0.35±0.13 vs. 0.48±0.04; P=0.02) compared to neonates with moderate HIE. For all subjects, basal ganglia NAA decreased (−0.08±0.07; P=0.01), whereas white matter GPC+PCh increased (0.03±0.04; P=0.04) from therapeutic hypothermia MRI to post-therapeutic-hypothermia MRI. All metabolite values are expressed in mmol/L.

Conclusion

Decreased NAA and GPC+PCh were associated with greater HIE severity and could distinguish neonates who might benefit most from targeted additional neuroprotective therapies.

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Title: Early proton magnetic resonance spectroscopy during and after therapeutic hypothermia in perinatal hypoxic–ischemic encephalopathy
Authors: Ashley M. Lucke
Anil N. Shetty
Joseph L. Hagan
Allison Walton
Tiffany D. Stafford
Zili D. Chu
Christopher J. Rhee
Jeffrey R. Kaiser
Magdalena Sanz Cortes
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Keyword: Encephalopathy
Published in: Pediatric Radiology / Issue 7/2019
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-019-04383-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Early proton magnetic resonance spectroscopy during and after therapeutic hypothermia in perinatal hypoxic–ischemic encephalopathy

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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