title: Early neurophysiology and MRI in predicting neurological outcome at 9-10 years after birth asphyxia.
abstract: OBJECTIVE
  To assess whether early somatosensory evoked potentials (SEP) predict long-term neurodevelopmental outcome in normothermic, full-term infants with mild to moderate neonatal encephalopathy (NE), and to compare their predictive value to already available amplitude integrated EEG (aEEG) and magnetic resonance imaging (MRI).
  
  
  METHODS
  Fifty-six infants with post-asphyxia NE were prospectively recruited, and their SEP, aEEG and MRI data were acquired during the first five days. Follow-up continued to 9-10 years for assessment of neuromotor and neurocognitive development. We analysed SEP latency (N1 component), normality of aEEG background pattern, as well as patterns of injury on the neonatal MRI. Neurological outcome measures at 9-10 years included conventional MRI, Movement-ABC and the WISC-III NL.
  
  
  RESULTS
  A SEP latency <50 ms during the first five days was associated with a normal neuromotor outcome (p < 0.03), and a prolonged day 3 latency was associated with lower childhood IQ (p = 0.02). The presence of multiple seizures in aEEG, as well as a moderate or severe injury on the neonatal MRI was associated with a poor neuromotor score (p = 0.03 and p < 0.01, respectively). Combination of multiple techniques improved prediction of long-term outcome compared to single modality.
  
  
  CONCLUSIONS
  Early SEPs provide information that is comparable to the already available aEEG and MRI paradigms in the prediction of long-term outcome of full-term infants with mild to moderate neonatal encephalopathy.
  
  
  CONCLUSIONS
  The present results call for further studies using early SEP to aid early assessment of infants treated with hypothermia.
authors: Department of Children's Clinical Neurophysiology, Helsinki University Hospital, and Department of Neurological Sciences, University of Helsinki, Finland. tea.kontio@helsinki.fi
authors: T
authors: T
authors: Kontio
authors: M C
authors: MC
authors: Toet
authors: L
authors: L
authors: Hellström-Westas
authors: M
authors: M
authors: van Handel
authors: F
authors: F
authors: Groenendaal
authors: S
authors: S
authors: Stjerna
authors: S
authors: S
authors: Vanhatalo
authors: L S
authors: LS
authors: de Vries
mesh_terms: D001238:Asphyxia Neonatorum / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002657:Child Development / Q000502:physiology; D002658:Developmental Disabilities / Q000209:etiology / Q000503:physiopathology; D004569:Electroencephalography; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D009460:Neurologic Examination; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology