A combined a-EEG and MR spectroscopy study in term newborns with hypoxic-ischemic encephalopathy.
OBJECTIVE
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 24h of life to brain metabolic changes detected by proton MR spectroscopy ((1)H-MRS) at 7-10days 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 (1)H-MRS examination at 7-10days of life; a-EEG was recorded during the first 24h 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 2years.


RESULTS
a-EEG at 6, 12 and 24h 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 24h of life showed improvement in newborns with normal (1)H-MRS and good outcome and a deterioration in those with abnormal (1)H-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 (1)H-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.
Ancora
Gina
G
Neonatology Unit, Department of Woman, Child and Adolescent Health, University of Bologna, Italy. gina.ancora@unibo.it
Soffritti
Silvia
S
Lodi
Raffaele
R
Tonon
Caterina
C
Grandi
Sara
S
Locatelli
Chiara
C
Nardi
Laura
L
Bisacchi
Nicoletta
N
Testa
Claudia
C
Tani
Giovanni
G
Ambrosetto
Paolo
P
Faldella
Giacomo
G
D001034:Apgar Score; D001479:Basal Ganglia / Q000378:metabolism / Q000473:pathology; D001921:Brain / Q000473:pathology; D001923:Brain Chemistry / Q000502:physiology; D002547:Cerebral Palsy / Q000209:etiology; D002657:Child Development / Q000502:physiology; D003627:Data Interpretation, Statistical; D004569:Electroencephalography; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology*; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009778:Occipital Lobe / Q000378:metabolism / Q000473:pathology; D010296:Parietal Lobe / Q000378:metabolism / Q000473:pathology; D011597:Psychomotor Performance / Q000502:physiology; D013534:Survival; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology