title: Prediction of neurodevelopmental outcome after hypoxic-ischemic encephalopathy treated with hypothermia by diffusion tensor imaging analyzed using tract-based spatial statistics.
abstract: BACKGROUND
  Objective biomarkers are needed to assess neuroprotective therapies after perinatal hypoxic-ischemic encephalopathy (HIE). We tested the hypothesis that, in infants who underwent therapeutic hypothermia after perinatal HIE, neurodevelopmental performance was predicted by fractional anisotropy (FA) values in the white matter (WM) on early diffusion tensor imaging (DTI) as assessed by means of tract-based spatial statistics (TBSS).
  
  
  METHODS
  We studied 43 term infants with HIE. Developmental assessments were carried out at a median (range) age of 24 (12-28) mo.
  
  
  RESULTS
  As compared with infants with favorable outcomes, those with unfavorable outcomes had significantly lower FA values (P < 0.05) in the centrum semiovale, corpus callosum (CC), anterior and posterior limbs of the internal capsule, external capsules, fornix, cingulum, cerebral peduncles, optic radiations, and inferior longitudinal fasciculus. In a second analysis in 32 assessable infants, the Griffiths Mental Development Scales (Revised) (GMDS-R) showed a significant linear correlation (P < 0.05) between FA values and developmental quotient (DQ) and all its component subscale scores.
  
  
  CONCLUSIONS
  DTI analyzed by TBSS provides a qualified biomarker that can be used to assess the efficacy of additional neuroprotective therapies after HIE.
authors.affiliation: Centre for the Developing Brain, Imperial College and MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK.
authors.forename: Nora
authors.initials: N
authors.lastname: Tusor
authors.forename: Courtney
authors.initials: C
authors.lastname: Wusthoff
authors.forename: Natalie
authors.initials: N
authors.lastname: Smee
authors.forename: Nazakat
authors.initials: N
authors.lastname: Merchant
authors.forename: Tomoki
authors.initials: T
authors.lastname: Arichi
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Allsop
authors.forename: Frances M
authors.initials: FM
authors.lastname: Cowan
authors.forename: Denis
authors.initials: D
authors.lastname: Azzopardi
authors.forename: A David
authors.initials: AD
authors.lastname: Edwards
authors.forename: Serena J
authors.initials: SJ
authors.lastname: Counsell
mesh_terms: D016880:Anisotropy; D015415:Biomarkers; D001921:Brain / Q000254:growth & development*; D002657:Child Development / Q000502:physiology*; D056324:Diffusion Tensor Imaging; D004739:England; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects* / Q000379:methods; D020925:Hypoxia-Ischemia, Brain / Q000503:physiopathology* / Q000628:therapy*; D007223:Infant; D007361:Intelligence Tests; D008297:Male; D056347:Neuroanatomical Tract-Tracing Techniques
chemical_list: D015415:Biomarkers