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Prognostic value of somatosensory-evoked potentials in the newborn with hypoxic-ischemic encephalopathy after the introduction of therapeutic hypothermia

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European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

To establish the ability of somatosensory-evoked potentials (SEPs) to detect neurological damage in neonatal patients with hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH). Retrospective study including 84 neonates ≥ 36 weeks of gestational age with HIE and TH with SEPs performed in the first 14 days of life. SEPs from the median nerve were performed after completion of TH. Either unilateral or bilateral absence of N20, or unilateral or bilateral latency ≥ 36 ms, was considered pathological. All newborns underwent a cerebral resonance imaging (MRI) at between days 7 and 14 of life and a neurodevelopmental evaluation using the Brunet-Lezine test at two years of age; a global Brunet-Lezine test score < 70 was considered unfavorable. The risk of moderate-to-severe alteration on basal ganglia–thalamic (BGT) and/or white matter areas on MRI for pathological SEPs was as follows: odds ratio 95% IC: 23.1 (6.9–76.9), sensitivity 78.6%, specificity 86.3%, positive predictive value 75.9%, and negative predictive value 88%. The BGT and internal capsule were the areas with the greatest risk of lesion with an altered SEPs: odds ratio 95% IC 93.1 (11.1–777.8). The risk of neurodevelopmental impairment for pathological SEPs was odds ratio 95% IC: 38.5 (4.4–335.3), sensitivity 91.7%, specificity 77.8% positive predictive value 52.4%, and negative predictive value 97.2%.

Conclusion: The present study demonstrates the good predictive capacity of SEPs performed in the first two weeks of life in newborns with HIE and TH to detect an increased risk of neuroimaging lesions and neurodevelopmental impairment at two years of age.

What is Known:

• Bilateral absence of the N20 cortical component of somatosensory evoked potentials has been associated with poor neurological outcome in neonates with hypoxic-ischemic encephalopathy.

What is New:

• This work confirms the predictive capacity of SEPs by adding two important aspects: the value of latency when interpreting SEPs results and the absence of effect of the hypothermia method used on the results of SEPs.

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The data are under the custody of the principal investigator.

Abbreviations

aEEG:

Amplitude integrated electroencephalography

BGT:

Basal ganglia–thalamic area

CS:

Cerebral selective hypothermia

Sp:

Specificity

HIE:

Hypoxic-ischemic encephalopathy

IC:

Internal capsule

MRI:

Magnetic resonance imaging

NPV :

Negative predictive value

PPV :

Positive predictive value

S:

Sensitivity

SEPs:

Somatosensory-evoked potentials

TH:

Therapeutic hypothermia

WB:

Whole body hypothermia

WM:

White matter

VEPs:

Visual evoked potentials

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Author information

Authors and Affiliations

  1. Neonatology Department, Neonatology Division, Gregorio Marañón University Hospital, C/Maiquez 9, 28009, Madrid, Spain

    María Arriaga-Redondo, Dorotea Blanco Bravo & Manuel Sánchez-Luna

  2. Radiology Department, Gregorio Marañón University Hospital, Madrid, Spain

    Alejandra Aguado del Hoyo & Yolanda Ruiz Martín

  3. Neurophysiology Department, Gregorio Marañón University Hospital, Madrid, Spain

    Ana Polo Arrondo

Authors
  1. María Arriaga-Redondo
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  2. Dorotea Blanco Bravo
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  3. Alejandra Aguado del Hoyo
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  4. Ana Polo Arrondo
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  5. Yolanda Ruiz Martín
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  6. Manuel Sánchez-Luna
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Contributions

D.B.B. and M.A.R. designed the study. M.A.R., A.A.H., A.P.A., and Y.R.M. participated in the acquisition of the data. M.A.R. carried out the analysis. M.A.R., D.B.B., M.S.L., A.A.H., and A.P.A contributed to the interpretation of the data. M.A.R. wrote the article and D.B.B., M.S.L., A.A.H., and A.P.A revised it critically. All the authors approved the final version of the manuscript to be published and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to María Arriaga-Redondo.

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This study was approved by the Ethics Committee of the Hospital.

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The authors declare no competing interests.

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Communicated by Daniele De Luca

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Arriaga-Redondo, M., Bravo, D.B., del Hoyo, A.A. et al. Prognostic value of somatosensory-evoked potentials in the newborn with hypoxic-ischemic encephalopathy after the introduction of therapeutic hypothermia. Eur J Pediatr 181, 1609–1618 (2022). https://doi.org/10.1007/s00431-021-04336-0

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  • DOI: https://doi.org/10.1007/s00431-021-04336-0

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