Association of network connectivity via resting state functional MRI with consciousness, mortality, and outcomes in neonatal acute brain injury.

Autor:	Boerwinkle VL; Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA. Electronic address: vboerwinkle@phoenixchildrens.com., Sussman BL; Department of Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA., Manjón I; University of Arizona College of Medicine - Tucson, 1501 N. Campbell Ave, Tucson, AZ 85724, USA., Mirea L; Department of Clinical Research, Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA., Suleman S; Division of Pediatric Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA., Wyckoff SN; Department of Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA., Bonnell A; Department of Neuroscience Research, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA., Orgill A; Department of Clinical Research, Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA., Tom DJ; Division of Neonatology, Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA.
Jazyk:	angličtina
Zdroj:	NeuroImage. Clinical [Neuroimage Clin] 2022; Vol. 34, pp. 102962. Date of Electronic Publication: 2022 Feb 09.
DOI:	10.1016/j.nicl.2022.102962
Abstrakt:	Background: An accurate and comprehensive test of integrated brain network function is needed for neonates during the acute brain injury period to inform on morbidity. This retrospective cohort study assessed whether integrated brain network function acquired by resting state functional MRI during the acute period in neonates with brain injury, is associated with acute exam, neonatal mortality, and 6-month outcomes. Methods: Study subjects included 40 consecutive neonates with resting state functional MRI acquired within 31 days after suspected brain insult from March 2018 to July 2019 at Phoenix Children's Hospital. Acute-period exam and test results were assigned ordinal scores based on severity as documented by respective treating specialists. Analyses (Fisher exact, Wilcoxon-rank sum test, ordinal/multinomial logistic regression) examined association of resting state networks with demographics, presentation, neurological exam, electroencephalogram, anatomical MRI, magnetic resonance spectroscopy, passive task functional MRI, and outcomes of discharge condition, outpatient development, motor tone, seizure, and mortality. Results: Subjects had a mean (standard deviation) gestational age of 37.8 (2.6) weeks, a majority were male (63%), with a diagnosis of hypoxic ischemic encephalopathy (68%). Findings at birth included mild distress (48%), moderately abnormal neurological exam (33%), and consciousness characterized as awake but irritable (40%). Significant associations after multiple testing corrections were detected for resting state networks: basal ganglia with outpatient developmental delay (odds ratio [OR], 14.5; 99.4% confidence interval [CI], 2.00-105; P < .001) and motor tone/weakness (OR, 9.98; 99.4% CI, 1.72-57.9; P < .001); language/frontoparietal network with discharge condition (OR, 5.13; 99.4% CI, 1.22-21.5; P = .002) and outpatient developmental delay (OR, 4.77; 99.4% CI, 1.21-18.7; P=.002); default mode network with discharge condition (OR, 3.72; 99.4% CI, 1.01-13.78; P=.006) and neurological exam (P = .002 (FE); OR, 11.8; 99.4% CI, 0.73-191; P = .01 (OLR)); and seizure onset zone with motor tone/weakness (OR, 3.31; 99.4% CI, 1.08-10.1; P=.003). Resting state networks were not detected in three neonates, who died prior to discharge. Conclusions: This study provides level 3 evidence (OCEBM Levels of Evidence Working Group) demonstrating that in neonatal acute brain injury, the degree of abnormality of resting state networks is associated with acute exam and outcomes. Total lack of brain network detection was only found in patients who did not survive. (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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