Brain volumes and functional outcomes in children without cerebral palsy after therapeutic hypothermia for neonatal hypoxic-ischaemic encephalopathy.
Arthur P C Spencer, Richard Lee-Kelland, Jonathan C W Brooks and 5 others
PMID 35907252WHAT IT FOUND
Children without cerebral palsy after neonatal cooling had smaller whole-brain grey and white matter volumes than controls.
Smaller hippocampal and thalamic volumes correlated with lower IQ and motor scores in these children. No significant differences remained when accounting for total brain size.
Key findings
01Patients had significantly reduced whole-brain grey matter and white matter volumes compared to controls.
02In patients, full-scale IQ and motor scores significantly correlated with hippocampal and thalamic volumes, independent of total brain volume.
03Patients with any cortical injury on neonatal MRI had significantly reduced hippocampal, thalamic, grey, and white matter volumes at school age.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was small, with only 31 patients and 32 controls included after exclusions due to movement artefacts, which limits the power to detect subtle differences. The study was exploratory and not hypothesis-driven for all analyses, increasing the risk of false positives. Subgroup analyses for injury sites other than cortex had very small sample sizes, preventing firm conclusions. The study did not investigate associations with subscales of cognitive and motor assessments to preserve statistical power. Patients excluded due to poor scan quality had significantly lower Apgar scores, suggesting the analysed cohort may not represent the full spectrum of severity.
Declared interests
The study was funded by the Baily Thomas Charitable Fund, David Telling Charitable Trust, Sparks, and the Moulton Foundation. One author is supported by the Wellcome Trust.
The easy way to misread this
Do not conclude that subcortical structures are disproportionately affected in isolation. The reduced volumes of the hippocampus and thalamus were not independent of total brain volume, meaning the differences may reflect a global reduction in brain size rather than specific focal injury to these structures alone.