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Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Multimodal Outcome at 7 Years of Age after Neonatal Arterial Ischemic Stroke
Stéphane Chabrier1, Emeline Peyric2, Laure Drutel2
1Centre Hospitalier Universitaire (CHU) Saint-Étienne, French Center for Pediatric Stroke/Pediatric Physical and Rehabilitation Medicine Department and Institut national de la santé et de la recherche médicale Centre d'investigation Clinique (INSERM CIC) 1408, Saint-Étienne, France; INSERM and University of Lyon, Dysfonction vasculaire et hémostase (DVH) Team-Unité mixte de recherche (UMR) 1090 Sainbiose, Saint-Étienne, France.
Insights
Neonatal arterial ischemic stroke (NAIS) survivors often show developmental impairments by age 7. While severe disabilities are infrequent, most children experience some form of developmental delay or academic challenges.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neuroscience
Background:
- Neonatal arterial ischemic stroke (NAIS) is a significant cause of brain injury in term newborns.
- Long-term neurodevelopmental outcomes following NAIS require comprehensive evaluation.
Purpose of the Study:
- To assess the epileptic, academic, and developmental status at age 7 years in term-born children with NAIS.
- To determine the co-occurrence of these neurodevelopmental outcomes.
Main Methods:
- A cohort study followed 80 term newborns diagnosed with NAIS through to age 7.
- Evaluated epileptic status, academic performance, motor abilities, intellectual functioning, and spoken language.
- Utilized principal component analysis to analyze outcomes.
Main Results:
- At age 7, 49% had impaired language, 32% had cerebral palsy, 28% had low academic skills, 11% had active epilepsy, and 8% had global intellectual deficiency.
- Fifty-nine percent of children experienced at least one significant impairment.
- Parental and health practitioner viewpoints diverged in 30% of cases.
Conclusions:
- Severe disabilities are uncommon in children with NAIS by age 7.
- However, the majority of survivors exhibit some form of developmental impairment.
- Early identification and intervention are crucial for managing long-term outcomes.
Objectives:
To evaluate the epileptic, academic, and developmental status at age 7 years in a large population of term-born children who sustained neonatal arterial ischemic stroke (NAIS), and to assess the co-occurrence of these outcomes.
Study Design:
A cohort study including 100 term newborns with NAIS was designed. Two infants died during the neonatal period, 13 families were lost to follow-up, and 5 families declined to participate in this evaluation. Thus, 80 families completed the 7-year clinical assessment. Epileptic status, schooling, motor abilities, global intellectual functioning, spoken language, and parental opinions were recorded. Principal component analysis was applied.
Results:
Rates of impaired language, cerebral palsy, low academic skills, active epilepsy, and global intellectual deficiency were 49%, 32%, 28%, 11%, and 8%, respectively. All were highly correlated. Eventually, 59% of children were affected by at least 1 of the aforementioned conditions. In 30% of cases, the viewpoints of health practitioners and parents did not match.
Conclusion:
The prevalence of severe disabilities at 7 years after NAIS is low, but most children exhibit some impairment in developmental profile.
Trial Registration:
ClinicalTrials.gov (NCT02511249), Programme Hospitalier de Recherche Clinique Régional (0308052), Programme Hospitalier de Recherche Clinique Interrégional (1008026), and EudraCT (2010-A00329-30).
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