Disrupted brain connectivity in children treated with therapeutic hypothermia for neonatal encephalopathy

Spencer, Arthur P. C., Brooks, Jonathan C. W., Masuda, Naoki, Byrne, Hollie, Lee-Kelland, Richard, Jary, Sally, Thoresen, Marianne, Tonks, James, Goodfellow, Marc, Cowan, Frances M. and Chakkarapani, Ela (2021) Disrupted brain connectivity in children treated with therapeutic hypothermia for neonatal encephalopathy. NeuroImage: Clinical, 30. ISSN 2213-1582

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Abstract

Therapeutic hypothermia following neonatal encephalopathy due to birth asphyxia reduces death and cerebral palsy. However, school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal encephalopathy still have reduced performance on cognitive and motor tests, attention difficulties, slower reaction times and reduced visuo-spatial processing abilities compared to typically developing controls. We acquired diffusion-weighted imaging data from school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal encephalopathy at birth, and a matched control group. Voxelwise analysis (33 cases, 36 controls) confirmed reduced fractional anisotropy in widespread areas of white matter in cases, particularly in the fornix, corpus callosum, anterior and posterior limbs of the internal capsule bilaterally and cingulum bilaterally. In structural brain networks constructed using probabilistic tractography (22 cases, 32 controls), graph-theoretic measures of strength, local and global efficiency, clustering coefficient and characteristic path length were found to correlate with IQ in cases but not controls. Network-based statistic analysis implicated brain regions involved in visuo-spatial processing and attention, aligning with previous behavioural findings. These included the precuneus, thalamus, left superior parietal gyrus and left inferior temporal gyrus. Our findings demonstrate that, despite the manifest successes of therapeutic hypothermia, brain development is impaired in these children.

Item Type: Article
Additional Information: This work was supported by the Baily Thomas Charitable Fund (TRUST/VC/AC/SG4681-7596), David Telling Charitable Trust, as well as Sparks (05/BTL/01 and 14/BTL/01) and the Moulton Foundation. AS is supported by the Wellcome Trust (WT220070/Z/20/Z). JB is supported by the UK Medical Research Council (MR/N026969/1). MG is supported by the EPSRC (EP/N014391/1) and by a Wellcome Trust Institutional Strategic Support Award (WT105618MA).
Uncontrolled Keywords: neonatal encephalopathy,therapeutic hypothermia,white matter,structural connectivity,brain networks,diffusion-weighted imaging,hypoxic-ischemic encephalopathy,posterior cingulate cortex,9-to 10-year-old children,human cerebral-cortex,white-matter,diffusion mri,spatial statistics,human connectome,structural connectivity,default mode,clinical neurology,neurology,cognitive neuroscience,radiology nuclear medicine and imaging ,/dk/atira/pure/subjectarea/asjc/2700/2728
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Depositing User: LivePure Connector
Date Deposited: 10 Feb 2022 10:30
Last Modified: 27 Apr 2022 00:34
URI: https://ueaeprints.uea.ac.uk/id/eprint/83400
DOI: 10.1016/j.nicl.2021.102582

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