Resting State Functional MRI Association with Consciousness, Mortality, and Long-term Seizure and Developmental Outcomes in Neonatal Acute Brain Injury
Abstract number :
1.234
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2022
Submission ID :
2203952
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Varina Boerwinkle, MD – University of North Carolina Chapel Hill; Kim Allred, RN – Phoenix Children's Hospital; Jordan Broman-fulks, MD – UNCCH; Senyene Hunter, MD, PhD – UNC; Iliana Manjon, MS4 – Arizona State University; Alyssa McGary, PhD – Phoenix Children's Hospital; Bethany Sussman, PhD – Phoenix Children's Hospital; Deborah Tom, MD – Phoenix Children's Hospital; Sarah Wyckoff, PhD – Phoenix Children's Hospital
This abstract has been invited to present during the Clinical Research platform session
Rationale: 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 2 year 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 at two years.
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%).
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Significant associations after multiple testing corrections were detected for resting state networks: basal ganglia with incremental outpatient outpatient mortality (odds ratio [OR], 65.7; 99.4% confidence interval [CI], 1.47–>999; P =0.005), motor tone/weakness (OR, 17.8; 99.4% CI, 12.2-; P < 0.001), seizures (OR, 57.5; 99.4% CI, 1.35->999; P=0.006), and PCPC (OR, 9.54; 99.4% CI, 1.89-48.1; P=0.0003); language/frontoparietal network with incremental developmental delay (OR, 3.64; 99.4% CI, 1.02-13.05; P = 0.009), outpatient mortality (OR, 9.2; 99.4% CI, 0.91-92.6; P < 0.01), and PCPC (OR, 3.98; 99.4% CI, 1.09-14.45; P=0.006); default mode network with incremental developmental delay (OR, 4.14; 99.4% CI, 1.19-14.43; P = 0.003), motor tone/weakness (OR, 3.35; 99.4% CI, 1.01-11.12 P < 0.009), seizures (OR, 20.41; 99.4% CI, 0.89-468; P=0.01), and PCPC (OR, 4.1; 99.4% CI, 1.2-14.2; P=0.004); and seizure onset zone with incremental seizures (OR, 4.02; 99.4% CI, 1.0-16.15; P=0.01).
Clinical Epilepsy