title: Region-specific reduction in brain volume in young adults with perinatal hypoxic-ischaemic encephalopathy.
abstract: BACKGROUND
  A severe form of perinatal hypoxic-ischaemic encephalopathy (HIE) carries a high risk of perinatal death and severe neurological sequelae while in mild HIE only discrete cognitive disorders may occur.
  
  
  OBJECTIVE
  To compare total brain volumes and region-specific cortical measurements between young adults with mild-moderate perinatal HIE and a healthy control group of the same age.
  
  
  METHODS
  MR imaging was performed in a cohort of 14 young adults (9 males, 5 females) with a history of mild or moderate perinatal HIE. The control group consisted of healthy participants, matched with HIE group by age and gender. Volumetric analysis was done after the processing of MR images using a fully automated CIVET pipeline. We measured gyrification indexes, total brain volume, volume of grey and white matter, and of cerebrospinal fluid. We also measured volume, thickness and area of the cerebral cortex in the parietal, occipital, frontal, and temporal lobe, and of the isthmus cinguli, parahippocampal and cingulated gyrus, and insula.
  
  
  RESULTS
  The HIE patient group showed smaller absolute volumetric data. Statistically significant (p < 0.05) reductions of gyrification index in the right hemisphere, of cortical areas in the right temporal lobe and parahippocampal gyrus, of cortical volumes in the right temporal lobe and of cortical thickness in the right isthmus of the cingulate gyrus were found. Comparison between the healthy group and the HIE group of the same gender showed statistically significant changes in the male HIE patients, where a significant reduction was found in whole brain volume; left parietal, bilateral temporal, and right parahippocampal gyrus cortical areas; and bilateral temporal lobe cortical volume.
  
  
  CONCLUSIONS
  Our analysis of total brain volumes and region-specific corticometric parameters suggests that mild-moderate forms of perinatal HIE lead to reductions in whole brain volumes. In the study reductions were most pronounced in temporal lobe and parahippocampal gyrus.
authors.affiliation: Department of Paediatric Neurology, University Children's Hospital, University Medical Centre Ljubljana, Bohoriceva 20, 1000 Ljubljana, Slovenia. Electronic address: tina.bregantdrmed@gmail.com.
authors.forename: Tina
authors.initials: T
authors.lastname: Bregant
authors.forename: Milan
authors.initials: M
authors.lastname: Rados
authors.forename: Lana
authors.initials: L
authors.lastname: Vasung
authors.forename: Metka
authors.initials: M
authors.lastname: Derganc
authors.forename: Alan C
authors.initials: AC
authors.lastname: Evans
authors.forename: David
authors.initials: D
authors.lastname: Neubauer
authors.forename: Ivica
authors.initials: I
authors.lastname: Kostovic
mesh_terms: D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009422:Nervous System Diseases / Q000150:complications; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Development; Hypoxia-ischaemia; MRI-volumetry; Perinatal brain injury; Very longterm follow-up