Mammillary body abnormalities and cognitive outcomes in children cooled for neonatal encephalopathy

Spencer, Arthur P. C., Lequin, Maarten H., de Vries, Linda S., Brooks, Jonathan C. W. ORCID:, Jary, Sally, Tonks, James, Cowan, Frances M., Thoresen, Marianne and Chakkarapani, Ela (2023) Mammillary body abnormalities and cognitive outcomes in children cooled for neonatal encephalopathy. Developmental Medicine and Child Neurology, 65 (6). pp. 792-802. ISSN 0012-1622

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Aim: To evaluate mammillary body abnormalities in school-age children without cerebral palsy treated with therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy (cases) and matched controls, and associations with cognitive outcome, hippocampal volume, and diffusivity in the mammillothalamic tract (MTT) and fornix.  Method: Mammillary body abnormalities were scored from T1-weighted magnetic resonance imaging (MRI) in 32 cases and 35 controls (median age [interquartile range] 7 years [6 years 7 months-7 years 7 months] and 7 years 4 months [6 years 7 months-7 years 7 months] respectively). Cognition was assessed using the Wechsler Intelligence Scale for Children, Fourth Edition. Hippocampal volume (normalized by total brain volume) was measured from T1-weighted MRI. Radial diffusivity and fractional anisotropy were measured in the MTT and fornix, from diffusion-weighted MRI using deterministic tractography.  Results: More cases than controls had mammillary body abnormalities (34% vs 0%; p < 0.001). Cases with abnormal mammillary bodies had lower processing speed (p = 0.016) and full-scale IQ (p = 0.028) than cases without abnormal mammillary bodies, and lower scores than controls in all cognitive domains (p < 0.05). Cases with abnormal mammillary bodies had smaller hippocampi (left p = 0.016; right p = 0.004) and increased radial diffusivity in the right MTT (p = 0.004) compared with cases without mammillary body abnormalities.  Interpretation: Cooled children with mammillary body abnormalities at school-age have reduced cognitive scores, smaller hippocampi, and altered MTT microstructure compared with those without mammillary body abnormalities, and matched controls.

Item Type: Article
Additional Information: Funding information: Baily Thomas Charitable Fund. Grant Number: TRUST/VC/AC/SG4681-7596; David Telling Charitable Trust; Medical Research Council. Grant Number: MR/N026969/1; Sparks. Grant Numbers: 05/BTL/01, 14/BTL/01; The Moulton Foundation; Wellcome Trust. Grant Number: WT220070/Z/20/Z.
Uncontrolled Keywords: diffusion mri,images,bodies
Faculty \ School: Faculty of Social Sciences > School of Psychology
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Depositing User: LivePure Connector
Date Deposited: 14 Nov 2022 11:30
Last Modified: 09 May 2023 14:30
DOI: 10.1111/dmcn.15453

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