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Cooling Reduces Brain Injury for Oxygen-Starved Babies

Prognosis after therapeutic cooling can be predicted with magnetic resonance imaging

MONDAY, Nov. 9 (HealthDay News) -- Babies who are starved of oxygen at birth have less brain injury if they are therapeutically cooled than if they are not, and the likelihood of death or disability in these infants can be accurately predicted using MRI, according to a study published online Nov. 6 in The Lancet Neurology.

Mary Rutherford, of Hammersmith Hospital in London, and colleagues conducted a study of 325 infants who were starved of oxygen at birth and suffered subsequent hypoxic-ischemic encephalopathy and who were randomized to receive intensive care with or without total body hypothermia. The babies underwent MRI of cerebral lesions to assess the efficacy of the treatment.

There were images available for 131 of the infants, and these showed that therapeutic hypothermia was associated with fewer lesions in the basal ganglia or thalamus, white matter and abnormal posterior limb of the internal capsule, the researchers found. Cooled infants had fewer MRI scans predictive of later neuromotor abnormalities than the non-cooled infants, the investigators note. The scans' accuracy in predicting death or disability up to 18 months of age was 0.84 in the cooled group and 0.81 in the non-cooled group.

"Our finding that MRI at a median of eight days accurately predicted outcome at 18 months of age in cooled and non-cooled infants is likely to be generally applicable," the authors write. "These data show that MRI in the neonatal period is qualified as a biomarker of disease and treatment response and might be of use in other neuroprotective studies."

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