A combined a-EEG and MR spectroscopy study in term newborns with hypoxic–ischemic encephalopathy

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• 作者：Gina Ancora ; Silvia Soffritti ; Raffaele Lodi ; Caterina Tonon ; Sara Gr ; i ; Chiara Locatelli ; Laura Nardi ; Nicoletta Bisacchi ; Claudia Testa ; Giovanni Tani ; Paolo Ambrosetto ; Giacomo Faldella
• 关键词：Hypoxic– ; ischemic encephalopathy ; Amplitude integrated electroencephalogram ; Proton magnetic resonance spectroscopy ; Cerebral palsy ; a-EEG time course
• 刊名：Brain and Development
• 出版年：2010
• 出版时间：November 2010
• 年：2010
• 卷：32
• 期：10
• 页码：835-842
• 全文大小：173 K

文摘

Objectives

Brain damage following a perinatal hypoxic–ischemic (HI) insult has been documented by different diagnostic techniques. The aim of the present study was to relate a-EEG time course during the first 24 h of life to brain metabolic changes detected by proton MR spectroscopy (¹H-MRS) at 7–10 days of life and to evaluate their correlation with outcome.

Methods

Thirty-two patients with any grade HI encephalopathy were studied. Thirty-one out of 32 patients survived and underwent ¹H-MRS examination at 7–10 days of life; a-EEG was recorded during the first 24 h of life in 27/32 newborns; 26 patients underwent both examinations. Griffiths test, evaluation of motor skills, visual and hearing function were performed at regular intervals until the age of 2 years.

Results

a-EEG at 6, 12 and 24 h of life showed a significant correlation with outcome. N-acetyl-aspartate/creatine (Cr), Lactate/Cr and myo-inositol differed significantly between patients with normal or poor outcome. a-EEG time course during the first 24 h of life showed improvement in newborns with normal ¹H-MRS and good outcome and a deterioration in those with abnormal ¹H-MRS and poor outcome.

Conclusions

a-EEG time course may be able to document the severity and the evolution of the cerebral damage following an HI event. a-EEG is related to the severity of cerebral injury as defined by ¹H-MRS and both examinations showed a good correlation with outcome. These data, obtained in non-cooled infants, may represent reference data for future investigations in cooled infants.