Association between Early Basal Ganglia and Thalami Perfusion Assessed by Color Doppler Ultrasonography and Brain...

Area of Science:

• Neonatal Neurology
• Pediatric Neuroimaging
• Cerebral Perfusion Assessment

Background:

• Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal brain injury.
• Accurate early assessment of HIE severity is crucial for timely intervention and prognostication.
• Current neuroimaging methods may have limitations in early prediction of long-term outcomes.

Purpose of the Study:

• To investigate the association between early basal ganglia (BG) and thalamic (Th) perfusion measurements using color Doppler ultrasonography (CDUS) and neurologic outcomes in infants with HIE.
• To determine if CDUS perfusion metrics can predict brain injury severity and long-term disability.

Main Methods:

• Prospective study involving infants with varying degrees of HIE and healthy controls.
• Color Doppler ultrasonography (CDUS) performed at 24-36 hours of age to measure BG and Th perfusion.
• Brain MRI conducted at a median of 10 days; neurodevelopmental follow-up through 2.5-5 years.
• Therapeutic hypothermia (TH) administered to infants with moderate-to-severe HIE.

Main Results:

• Increased BG and Th perfusion on CDUS correlated with severe brain MRI scores and significant long-term motor and neurosensory disability or death.
• Infants with severe HIE exhibited significantly higher BG and Th perfusion compared to those with moderate HIE.
• Thalamic perfusion threshold of ≥0.237 cm/second demonstrated 80% accuracy in classifying infants with severe MRI scores.

Conclusions:

• Early dynamic CDUS assessment of BG and Th perfusion serves as a potential biomarker for identifying severe brain injury in HIE infants.
• CDUS offers a valuable, non-invasive adjunct to existing assessments for predicting neurologic outcomes in HIE.
• This technique may improve early risk stratification and management strategies for neonates with HIE.