Objective dystonia prediction with MRI after neonatal hypoxic-ischemic encephalopathy
Objective dystonia prediction with MRI after neonatal hypoxic-ischemic encephalopathy
Abstract AimTo determine an objective and clinically-feasible method to predict dystonia in cerebral palsy (CP) using magnetic resonance imaging (MRI) following neonatal hypoxic-ischemic encephalopathy (HIE). MethodsIn this retrospective case-control study, we examined brain MRIs in neonates at age 4–5 days who underwent therapeutic hypothermia for HIE at a single tertiary care center. The lower average apparent diffusion coefficient (ADC) values between the left and right striatum and thalamus were determined using clinically-integrated software (IBM iConnect Access). Neonatal neurology, movement disorder, and cerebral palsy specialist notes were screened through age 5 years for motor abnormality documentation. ResultsIn 50 subjects, ADC values significantly predicted dystonia in CP with receiver operator characteristic areas under the curve of 0.862 (p = 0.0004) in the striatum and 0.838 (p = 0.001) in the thalamus. Striatal ADC values less than 1.014×10?3 mm2/s provided 100% specificity and 70% sensitivity for dystonia. Thalamic ADC values less than 0.973×10?3 mm2/s provided 100% specificity and 80% sensitivity for dystonia. InterpretationIn this small retrospective study, analysis of clinically-acquired MRIs predicted dystonia with high specificity following neonatal HIE. This could be a useful prognostication adjunct guiding when to establish appropriate vigilance for dystonia in CP.
Chintalapati Keerthana、Miao Hanyang、Mathur Amit、Neil Jeff、Aravamuthan Bhooma R.
Department of NeurologyDepartment of NeurologyDepartment of PediatricsDepartment of NeurologyDepartment of Neurology
神经病学、精神病学医学研究方法基础医学
Chintalapati Keerthana,Miao Hanyang,Mathur Amit,Neil Jeff,Aravamuthan Bhooma R..Objective dystonia prediction with MRI after neonatal hypoxic-ischemic encephalopathy[EB/OL].(2025-03-28)[2025-05-17].https://www.medrxiv.org/content/10.1101/2020.05.29.20116947.点此复制
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