Abstract Details

Title Early Neuroimaging Markers of Outcome in Neonatal HIE

Topic Child Neurology and Developmental Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 8-001

Objective To explore the predictive value of whole-brain and region-specific Z-scored Apparent Diffusion Coefficient (ZADC) abnormalities in gray matter (GM) and white matter (WM) as early neuroimaging markers for neurodevelopmental outcomes at two years in neonates with Hypoxic-Ischemic Encephalopathy (HIE).

Background Brain injury in HIE is characterized by a low ADC, which is associated with poor neurodevelopmental outcomes. Previous studies often used fixed regional thresholds, disregarding anatomical heterogeneity and the continuum of diffusion metrics. This study utilizes ZADC maps, which normalize voxel-wise ADC to region- and tissue-specific norms from a healthy neonatal cohort. This Z-score transformation provides a uniform scale for quantifying abnormal diffusion and injury severity across different brain tissues.

Design/Methods We analyzed 21 neonates with HIE (mean GA 38.23 weeks, 18 males, 62% with seizures, 62% treated with therapeutic hypothermia). Patient ADC maps were used to create ZADC maps by comparison to a normative ADC atlas. Z-scores were calculated for whole-brain and specific regions of interest in GM and WM, defined by the M-CRIB2.0 atlas. Multivariate regression was used to predict Bayley-4 domain scores at two years using regional ZADC values.

Results Significant correlations were found between regional ZADC values and neurodevelopmental outcomes. In GM, right lentiform nucleus ZADC significantly predicted Language Composite (p=0.004), Expressive Communication (p=0.001), and Gross Motor (p=0.001) scores. ZADC in the right occipital lobe, right hippocampus, and cerebellum individually predicted Fine Motor scores (p<0.05). In WM, ZADC in the left occipital lobe was a significant predictor of Cognitive Composite (p=0.018) and Language Composite (p=0.024) scores.

Conclusions ZADC deviations in key GM and WM regions may provide early biomarkers of motor, language, and cognitive impairments at two years in HIE neonates. This continuous, voxel-based analysis offers a more nuanced approach for prognostication. A small sample size was the primary limitation, and future multi-center collaborations are warranted.

Authors/Disclosures
Daniel Ackom PRESENTER	Mr. Ackom has nothing to disclose.
Janine E. Taitt, MBBS (Medical College of Wisconsin and Affiliated Hospitals)	Dr. Taitt has nothing to disclose.
Brianna Vega	Miss Vega has nothing to disclose.
Alyssa Jobe, BS	Ms. Jobe has nothing to disclose.
Andrew J. Crow, BA	The institution of Mr. Crow has received research support from Advancing a Healthier Wisconsin Endowment. The institution of Mr. Crow has received research support from Centers for Disease Control and Prevention. The institution of Mr. Crow has received research support from Children's Hospital of Wisconsin Foundation. The institution of Mr. Crow has received research support from Children's Research Institute. The institution of Mr. Crow has received research support from Pediatric Epilepsy Research Foundation.
Samuel Adams, MD (Children's Wisconsin)	Dr. Adams has nothing to disclose.
Scott Beardsley, PhD	Prof. Beardsley has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AGCS. The institution of Prof. Beardsley has received research support from Advancing a Healthier Wisconsin.
Brian Schmit, PhD	The institution of Dr. Schmit has received research support from National Institutes of Health. Dr. Schmit has received intellectual property interests from a discovery or technology relating to health care.
Pradeep Javarayee, MD (Medical College of Wisconsin)	Dr. Javarayee has nothing to disclose.

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