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Hyperglycemia associated with acute brain injury in neonatal encephalopathy

OBJECTIVE: To identify how alterations in glucose levels are associated with regional brain injury in neonatal encephalopathy. METHODS: This was a prospective cohort study of 102 newborns with neonatal encephalopathy, with continuous glucose monitoring for 72 h. 97 (95%) completed 72 h of therapeuti...

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Autores principales: Tam, Emily W.Y., Kamino, Daphne, Shatil, Anwar S., Chau, Vann, Moore, Aideen M., Brant, Rollin, Widjaja, Elysa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496301/
https://www.ncbi.nlm.nih.gov/pubmed/34601311
http://dx.doi.org/10.1016/j.nicl.2021.102835
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author Tam, Emily W.Y.
Kamino, Daphne
Shatil, Anwar S.
Chau, Vann
Moore, Aideen M.
Brant, Rollin
Widjaja, Elysa
author_facet Tam, Emily W.Y.
Kamino, Daphne
Shatil, Anwar S.
Chau, Vann
Moore, Aideen M.
Brant, Rollin
Widjaja, Elysa
author_sort Tam, Emily W.Y.
collection PubMed
description OBJECTIVE: To identify how alterations in glucose levels are associated with regional brain injury in neonatal encephalopathy. METHODS: This was a prospective cohort study of 102 newborns with neonatal encephalopathy, with continuous glucose monitoring for 72 h. 97 (95%) completed 72 h of therapeutic hypothermia. Brain imaging around day 5 of life included diffusion tensor imaging and MR spectroscopy. Regions of interest were placed for both DTI and MR spectroscopy, and tractography of the optic radiation and corticospinal tract were evaluated. Linear regression models related each MR metric with minimum and maximum glucose values during each day of life, adjusting for 5-minute Apgar scores and umbilical artery pH. RESULTS: Higher maximum glucose levels on the first day of life were associated with widespread changes in mean diffusivity in the anterior and posterior white matter, splenium of the corpus callosum, lentiform nucleus, pulvinar nucleus of the thalamus, posterior limb of the internal capsule, and optic radiations, thus including regions traditionally associated with hypoxia–ischemia or hypoglycemia. No associations were found between lower minimum glucose levels and DTI changes in any regions tested, or between glucose levels and MR spectroscopy. CONCLUSIONS: In this cohort of neonatal encephalopathy with therapeutic hypothermia, higher maximal glucose on the first day of life was associated with widespread microstructural changes, but lower minimum glucose levels were not associated with changes in any of the regions tested. Long-term follow-up will determine if imaging findings translate to long-term outcomes.
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spelling pubmed-84963012021-10-12 Hyperglycemia associated with acute brain injury in neonatal encephalopathy Tam, Emily W.Y. Kamino, Daphne Shatil, Anwar S. Chau, Vann Moore, Aideen M. Brant, Rollin Widjaja, Elysa Neuroimage Clin Regular Article OBJECTIVE: To identify how alterations in glucose levels are associated with regional brain injury in neonatal encephalopathy. METHODS: This was a prospective cohort study of 102 newborns with neonatal encephalopathy, with continuous glucose monitoring for 72 h. 97 (95%) completed 72 h of therapeutic hypothermia. Brain imaging around day 5 of life included diffusion tensor imaging and MR spectroscopy. Regions of interest were placed for both DTI and MR spectroscopy, and tractography of the optic radiation and corticospinal tract were evaluated. Linear regression models related each MR metric with minimum and maximum glucose values during each day of life, adjusting for 5-minute Apgar scores and umbilical artery pH. RESULTS: Higher maximum glucose levels on the first day of life were associated with widespread changes in mean diffusivity in the anterior and posterior white matter, splenium of the corpus callosum, lentiform nucleus, pulvinar nucleus of the thalamus, posterior limb of the internal capsule, and optic radiations, thus including regions traditionally associated with hypoxia–ischemia or hypoglycemia. No associations were found between lower minimum glucose levels and DTI changes in any regions tested, or between glucose levels and MR spectroscopy. CONCLUSIONS: In this cohort of neonatal encephalopathy with therapeutic hypothermia, higher maximal glucose on the first day of life was associated with widespread microstructural changes, but lower minimum glucose levels were not associated with changes in any of the regions tested. Long-term follow-up will determine if imaging findings translate to long-term outcomes. Elsevier 2021-09-28 /pmc/articles/PMC8496301/ /pubmed/34601311 http://dx.doi.org/10.1016/j.nicl.2021.102835 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Tam, Emily W.Y.
Kamino, Daphne
Shatil, Anwar S.
Chau, Vann
Moore, Aideen M.
Brant, Rollin
Widjaja, Elysa
Hyperglycemia associated with acute brain injury in neonatal encephalopathy
title Hyperglycemia associated with acute brain injury in neonatal encephalopathy
title_full Hyperglycemia associated with acute brain injury in neonatal encephalopathy
title_fullStr Hyperglycemia associated with acute brain injury in neonatal encephalopathy
title_full_unstemmed Hyperglycemia associated with acute brain injury in neonatal encephalopathy
title_short Hyperglycemia associated with acute brain injury in neonatal encephalopathy
title_sort hyperglycemia associated with acute brain injury in neonatal encephalopathy
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496301/
https://www.ncbi.nlm.nih.gov/pubmed/34601311
http://dx.doi.org/10.1016/j.nicl.2021.102835
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