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Neurobehavioral Assessments in a Mouse Model of Neonatal Hypoxic-ischemic Brain Injury
Published on: November 24, 2017
Long-term motor and behavioral outcome after perinatal hypoxic-ischemic encephalopathy
Petra E M van Schie1, Josephine Schijns2, Jules G Becher3
1Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; Department of Physical Therapy, VU University Medical Center, Amsterdam, The Netherlands.
Insights
Children with perinatal hypoxic-ischemic encephalopathy (HIE) often show impaired motor skills and behavioral issues by school age. Early normal outcomes or MRI scans do not guarantee long-term good health for HIE survivors.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
Background:
- Perinatal hypoxic-ischemic encephalopathy (HIE) affects newborns, necessitating long-term follow-up.
- Understanding the long-term neurodevelopmental trajectory after HIE is crucial for intervention.
Purpose of the Study:
- To assess motor and behavioral outcomes in school-aged children with a history of perinatal HIE.
- To investigate the relationship between neonatal MRI findings, early outcomes, and later school-age functioning in HIE survivors.
Main Methods:
- Prospective cohort study of 25 children with perinatal HIE, assessed around age 7.5 years.
- Utilized Movement Assessment Battery for Children and Child Behavior Checklist for outcome measures.
- Neonatal MRI analyzed using Barkovich classification.
Main Results:
- Eight children (32%) developed cerebral palsy (CP).
- Among those without CP, 53% exhibited impaired motor ability, and 24% had behavioral problems.
- Abnormal neonatal MRI significantly correlated with poorer motor performance (p=0.008).
Conclusions:
- A significant proportion of HIE survivors without CP still experience motor and behavioral deficits at school age.
- Normal early assessments, including MRI, do not preclude later functional impairments.
- Further research is needed on cognitive impacts and quality of life for HIE-affected children.
Background:
A cohort of children born with perinatal hypoxic-ischemic encephalopathy (HIE) was followed prospectively until school age.
Aims:
To describe motor outcome and behavioral functioning of school-age children after perinatal HIE and the relationship with neonatal MRI and outcome at age 2.
Methods:
Twenty-five children (19 males), born at term with perinatal HIE, were assessed at a mean age of 7 y 6 m (range 6 y 4 m-8 y 2 m). Motor ability was assessed with the Movement Assessment Battery for Children (2nd version) and behavioral functioning was assessed with the Child Behavior Checklist. Neonatal MRI was scored according to Barkovich classification.
Results:
Of the 25 included children, eight had cerebral palsy (CP). Of the 17 children without CP, nine had impaired motor ability (of which 3 scored definitely abnormal), and four had behavioral problems. There was a significant difference in motor performance (p = 0.008) between children with normal and children with abnormal neonatal MRI. Two (of four) children with normal motor ability and seven (of 14) children with normal neurological examination at age 2 showed impaired motor ability at school age.
Conclusions:
Half of the children without CP had impaired motor ability at school age. A normal outcome after HIE at young age does not necessarily imply a good outcome at school age, even when neonatal MRI does not show any abnormalities. More research is needed on the behavioral and cognitive consequences of HIE at school age and on the consequences for quality of life for children with and without CP.
