TY - JOUR
T1 - Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia
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
PY - 2017/11/6
Y1 - 2017/11/6
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
KW - Evoked potentials
KW - Neonatal encephalopathy
KW - Perinatal asphyxia
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U2 - 10.1016/j.clinph.2017.10.020
DO - 10.1016/j.clinph.2017.10.020
M3 - Article
AN - SCOPUS:85034778771
VL - 129
SP - 95
EP - 100
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
SN - 1388-2457
IS - 1
ER -