Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia

Agnese Suppiej, Ambra Cappellari, Giacomo Talenti, Elisa Cainelli, Matteo Di Capua, Augusta Janes, Daniela Longo, Rodica Mardari, Cristina Marinaccio, Stefano Pro, Paola Sciortino, Daniele Trevisanuto, Roberta Vittorini, Renzo Manara

Research output: Contribution to journalArticle

Abstract

Objective The introduction of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs). Methods Among 80 consecutive neonates undergoing hypothermia for hypoxic-ischemic encephalopathy, 58 performed SEPs and MRI at 4–14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20). The severity of brain injury was scored using MRI. Results Bilaterally absent N20 was observed in 10/58 neonates (17%); all had moderate/severe MRI abnormalities; 36/48 neonates (75%) with score 0 at SEPs had normal MRI. The positive predictive value of SEPs on MRI outcome was of 1.00, while the negative predictive value 0.72, sensitivity 0.48, specificity 1.00, with an accuracy of 0.78 (p <.001). Conclusions Bilateral absence of cortical SEPs predicts moderate/severe MRI pattern of injury. Significance Therapeutic hypothermia does not seem to significantly affect prognostic reliability of SEPs.

Original languageEnglish
Pages (from-to)95-100
Number of pages6
JournalClinical Neurophysiology
Volume129
Issue number1
DOIs
Publication statusE-pub ahead of print - Nov 6 2017

Fingerprint

Brain Hypoxia-Ischemia
Somatosensory Evoked Potentials
Hypothermia
Induced Hypothermia
Brain Injuries
Multicenter Studies
Sensitivity and Specificity
Wounds and Injuries

Keywords

  • Cooled infants
  • Evoked potentials
  • Neonatal encephalopathy
  • Perinatal asphyxia

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia. / Suppiej, Agnese; Cappellari, Ambra; Talenti, Giacomo; Cainelli, Elisa; Di Capua, Matteo; Janes, Augusta; Longo, Daniela; Mardari, Rodica; Marinaccio, Cristina; Pro, Stefano; Sciortino, Paola; Trevisanuto, Daniele; Vittorini, Roberta; Manara, Renzo.

In: Clinical Neurophysiology, Vol. 129, No. 1, 06.11.2017, p. 95-100.

Research output: Contribution to journalArticle

Suppiej, A, Cappellari, A, Talenti, G, Cainelli, E, Di Capua, M, Janes, A, Longo, D, Mardari, R, Marinaccio, C, Pro, S, Sciortino, P, Trevisanuto, D, Vittorini, R & Manara, R 2017, 'Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia', Clinical Neurophysiology, vol. 129, no. 1, pp. 95-100. https://doi.org/10.1016/j.clinph.2017.10.020
Suppiej, Agnese ; Cappellari, Ambra ; Talenti, Giacomo ; Cainelli, Elisa ; Di Capua, Matteo ; Janes, Augusta ; Longo, Daniela ; Mardari, Rodica ; Marinaccio, Cristina ; Pro, Stefano ; Sciortino, Paola ; Trevisanuto, Daniele ; Vittorini, Roberta ; Manara, Renzo. / Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia. In: Clinical Neurophysiology. 2017 ; Vol. 129, No. 1. pp. 95-100.
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AU - Suppiej, Agnese

AU - Cappellari, Ambra

AU - Talenti, Giacomo

AU - Cainelli, Elisa

AU - Di Capua, Matteo

AU - Janes, Augusta

AU - Longo, Daniela

AU - Mardari, Rodica

AU - Marinaccio, Cristina

AU - Pro, Stefano

AU - Sciortino, Paola

AU - Trevisanuto, Daniele

AU - Vittorini, Roberta

AU - Manara, Renzo

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N2 - Objective The introduction of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs). Methods Among 80 consecutive neonates undergoing hypothermia for hypoxic-ischemic encephalopathy, 58 performed SEPs and MRI at 4–14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20). The severity of brain injury was scored using MRI. Results Bilaterally absent N20 was observed in 10/58 neonates (17%); all had moderate/severe MRI abnormalities; 36/48 neonates (75%) with score 0 at SEPs had normal MRI. The positive predictive value of SEPs on MRI outcome was of 1.00, while the negative predictive value 0.72, sensitivity 0.48, specificity 1.00, with an accuracy of 0.78 (p <.001). Conclusions Bilateral absence of cortical SEPs predicts moderate/severe MRI pattern of injury. Significance Therapeutic hypothermia does not seem to significantly affect prognostic reliability of SEPs.

AB - Objective The introduction of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs). Methods Among 80 consecutive neonates undergoing hypothermia for hypoxic-ischemic encephalopathy, 58 performed SEPs and MRI at 4–14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20). The severity of brain injury was scored using MRI. Results Bilaterally absent N20 was observed in 10/58 neonates (17%); all had moderate/severe MRI abnormalities; 36/48 neonates (75%) with score 0 at SEPs had normal MRI. The positive predictive value of SEPs on MRI outcome was of 1.00, while the negative predictive value 0.72, sensitivity 0.48, specificity 1.00, with an accuracy of 0.78 (p <.001). Conclusions Bilateral absence of cortical SEPs predicts moderate/severe MRI pattern of injury. Significance Therapeutic hypothermia does not seem to significantly affect prognostic reliability of SEPs.

KW - Cooled infants

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KW - Neonatal encephalopathy

KW - Perinatal asphyxia

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