Pfister Katie M, Stoyell Sally M, Miller Zachary R, Hunt Ruskin H, Zorn Elizabeth P, Thomas Kathleen M
Department of Pediatrics, University of Minnesota, 2450 Riverside Ave., AO-401, Minneapolis, MN 55454, USA.
Institute of Child Development, University of Minnesota, Campbell Hall, 51 E River Rd., Minneapolis, MN 55455, USA.
Children (Basel). 2023 Jun 2;10(6):1005. doi: 10.3390/children10061005.
Hypoxic ischemic encephalopathy (HIE) remains a significant cause of disability despite treatment with therapeutic hypothermia (TH). Many survive with more subtle deficits that affect daily functioning and school performance. We have previously shown an early indication of hippocampal changes in infants with HIE despite TH. The aim of this study was to evaluate the hippocampal volume via MRI and memory function at 5 years of age. A cohort of children followed from birth returned for a 5-year follow-up ( = 10 HIE treated with TH, = 8 healthy controls). The children underwent brain MRI and neurodevelopmental testing to assess their brain volume, general development, and memory function. Children with HIE had smaller hippocampal volumes than the controls despite no differences in the total brain volume ( = 0.02). Children with HIE generally scored within the average range on developmental testing. Though there was no difference in the memory scores between these groups, there was a positive within-group correlation between the hippocampal volume and memory scores in children with HIE (sentence recall r = 0.66, = 0.038). There was no relationship between newborn memory function and 5-year hippocampal size. Children with HIE treated with TH experienced significant and lasting changes to the hippocampus despite improvements in survival and severe disability. Future studies should target diminishing injury to the hippocampus to improve overall outcomes.
尽管采用治疗性低温（TH）治疗，缺氧缺血性脑病（HIE）仍是导致残疾的重要原因。许多患儿存活下来，但存在更细微的缺陷，影响日常功能和学业表现。我们之前已经表明，尽管进行了TH治疗，HIE患儿海马体仍有早期变化迹象。本研究的目的是通过磁共振成像（MRI）评估5岁时的海马体体积和记忆功能。一组从出生就开始跟踪的儿童返回进行5年随访（n = 10例接受TH治疗的HIE患儿，n = 8例健康对照）。这些儿童接受了脑部MRI和神经发育测试，以评估他们的脑容量、总体发育和记忆功能。尽管总脑容量没有差异（P = 0.02），但HIE患儿的海马体体积小于对照组。HIE患儿在发育测试中的得分总体处于平均范围内。虽然这些组之间的记忆得分没有差异，但HIE患儿的海马体体积与记忆得分之间存在组内正相关（句子回忆r = 0.66，P = 0.038）。新生儿记忆功能与5岁时的海马体大小之间没有关系。尽管存活情况有所改善且严重残疾减少，但接受TH治疗的HIE患儿的海马体仍发生了显著且持久的变化。未来的研究应致力于减少对海马体的损伤，以改善总体预后。
