Advances in Neonatal Hypoxic–Ischemic Brain Injury

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: closed (10 June 2024) | Viewed by 5665

Special Issue Editor


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Guest Editor
Division of Neonatology, Department of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine University, 40225 Düsseldorf, Germany
Interests: neonatal neurology; perinatal brain injury; hypoxic–ischemic injury; stroke; neuroprotection; genetics
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Special Issue Information

Dear Colleagues,

Death and disability in children worldwide have their origin predominantly in the neonatal period and mainly arise from perinatal asphyxia and preterm birth. Birth asphyxia, leading to the clinical presentation of hypoxic–ischemic encephalopathy (HIE), affects to a large extent the term-born population, but preterm infants can also be affected. Prognosis following HIE and other types of neonatal brain injury including stroke is particularly poor. Despite remarkable advances in perinatal care, diagnosis and therapy of neonatal brain injury remain a challenge, and therapies are largely supportive. The only established clinical intervention for HIE is therapeutic hypothermia demonstrating reductions in risk of death or impairment. However, 40–50% of cooled infants still suffer from major neurological problems, and in preterm infants, therapeutic hypothermia cannot be applied due to side effects.  In recent years, established and new preclinical models have elucidated mechanisms promoting our understanding of neonatal brain injury, but unanswered questions remain. This Special issue welcomes submissions which explore clinical and experimental advances in neonatal hypoxic–ischemic brain injury and will compile the latest results to further support clinical translation.

Prof. Dr. Mark Dzietko
Guest Editor

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Keywords

  • brain
  • neuroprotection
  • encephalopathy
  • hypoxia ischemia
  • stroke
  • seizures
  • neuromonitoring
  • neuro-NICU

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Published Papers (3 papers)

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Research

16 pages, 4398 KiB  
Article
Effect of Clemastine on Neurophysiological Outcomes in an Ovine Model of Neonatal Hypoxic-Ischemic Encephalopathy
by Jana Krystofova Mike, Yasmine White, Rachel S. Hutchings, Christian Vento, Janica Ha, Ariana Iranmahboub, Hadiya Manzoor, Anya Gunewardena, Cheryl Cheah, Aijun Wang, Brian D. Goudy, Satyan Lakshminrusimha, Janel Long-Boyle, Jeffrey R. Fineman, Donna M. Ferriero and Emin Maltepe
Children 2023, 10(11), 1728; https://doi.org/10.3390/children10111728 - 25 Oct 2023
Cited by 3 | Viewed by 1622
Abstract
Originally approved by the U.S. Food and Drug Administration (FDA) for its antihistamine properties, clemastine can also promote white matter integrity and has shown promise in the treatment of demyelinating diseases such as multiple sclerosis. Here, we conducted an in-depth analysis of the [...] Read more.
Originally approved by the U.S. Food and Drug Administration (FDA) for its antihistamine properties, clemastine can also promote white matter integrity and has shown promise in the treatment of demyelinating diseases such as multiple sclerosis. Here, we conducted an in-depth analysis of the feasibility, safety, and neuroprotective efficacy of clemastine administration in near-term lambs (n = 25, 141–143 days) following a global ischemic insult induced via an umbilical cord occlusion (UCO) model. Lambs were randomly assigned to receive clemastine or placebo postnatally, and outcomes were assessed over a six-day period. Clemastine administration was well tolerated. While treated lambs demonstrated improvements in inflammatory scores, their neurodevelopmental outcomes were unchanged. Full article
(This article belongs to the Special Issue Advances in Neonatal Hypoxic–Ischemic Brain Injury)
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16 pages, 2998 KiB  
Article
Identification of Metabolomic Signatures for Ischemic Hypoxic Encephalopathy Using a Neonatal Rat Model
by Yulia Shevtsova, Chupalav Eldarov, Natalia Starodubtseva, Kirill Goryunov, Vitaliy Chagovets, Oleg Ionov, Egor Plotnikov and Denis Silachev
Children 2023, 10(10), 1693; https://doi.org/10.3390/children10101693 - 16 Oct 2023
Cited by 2 | Viewed by 1844
Abstract
A study was performed to determine early metabolomic markers of ischemic hypoxic encephalopathy (HIE) using a Rice–Vannucci model for newborn rats. Dried blood spots from 7-day-old male and female rat pups, including 10 HIE-affected animals and 16 control animals, were analyzed by liquid [...] Read more.
A study was performed to determine early metabolomic markers of ischemic hypoxic encephalopathy (HIE) using a Rice–Vannucci model for newborn rats. Dried blood spots from 7-day-old male and female rat pups, including 10 HIE-affected animals and 16 control animals, were analyzed by liquid chromatography coupled with mass spectrometry (HPLC-MS) in positive and negative ion recording modes. Multivariate statistical analysis revealed two distinct clusters of metabolites in both HPLC-MS modes. Subsequent univariate statistical analysis identified 120 positive and 54 negative molecular ions that exhibited statistically significant change in concentration, with more than a 1.5-fold difference after HIE. In the HIE group, the concentrations of steroid hormones, saturated mono- and triglycerides, and phosphatidylcholines (PCs) were significantly decreased in positive mode. On the contrary, the concentration of unsaturated PCs was increased in the HIE group. Among negatively charged molecular ions, the greatest variations were found in the categories of phosphatidylcholines, phosphatidylinositols, and triglycerides. The major metabolic pathways associated with changed metabolites were analyzed for both modes. Metabolic pathways such as steroid biosynthesis and metabolism fatty acids were most affected. These results underscored the central role of glycerophospholipid metabolism in triggering systemic responses in HIE. Therefore, lipid biomarkers’ evaluation by targeted HPLC-MS research could be a promising approach for the early diagnosis of HIE. Full article
(This article belongs to the Special Issue Advances in Neonatal Hypoxic–Ischemic Brain Injury)
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13 pages, 456 KiB  
Article
Correlation of Different MRI Scoring Systems with Long-Term Cognitive Outcome in Cooled Asphyxiated Newborns
by Ok-Hap Kang, Peter Jahn, Joachim G. Eichhorn, Till Dresbach, Andreas Müller and Hemmen Sabir
Children 2023, 10(8), 1295; https://doi.org/10.3390/children10081295 - 27 Jul 2023
Cited by 4 | Viewed by 1575
Abstract
(1) Background: Cerebral MRI plays a significant role in assessing the extent of brain injury in neonates with neonatal encephalopathy after perinatal asphyxia. Over the last decades, several MRI scoring systems were developed to enhance the predictive accuracy of MRI. The aim of [...] Read more.
(1) Background: Cerebral MRI plays a significant role in assessing the extent of brain injury in neonates with neonatal encephalopathy after perinatal asphyxia. Over the last decades, several MRI scoring systems were developed to enhance the predictive accuracy of MRI. The aim of this study was to validate the correlation of four established MRI scoring systems with cognitive long-term outcomes in cooled asphyxiated newborns. (2) Methods: Forty neonates with neonatal encephalopathy treated with therapeutic hypothermia were included in this retrospective study. The MRI scans from the second week of life were scored using four existing MRI scoring systems (Barkovich, NICHD, Rutherford, and Weeke). The patients’ outcome was assessed with the Bayley Scales of Infant Development (BSID-III) at the age of 2 years. To evaluate the correlation between the MRI scoring system with the cognitive scores of BSID-III, the correlation coefficient was calculated for each scoring system. (3) Results: All four MRI scoring systems showed a significant correlation with the cognitive scores of BSID-III. The strongest correlation was found between the Weeke Score (r2 = 0.43), followed by the Rutherford score (r2 = 0.39), the NICHD score (r2 = 0.22), and the Barkovich score (r2 = 0.17). (4) Conclusion: Our study confirms previously published results in an independent cohort and indicates that the Weeke and Rutherford scores have the strongest correlation with the cognitive score of BSID-III in cooled asphyxiated newborns. Full article
(This article belongs to the Special Issue Advances in Neonatal Hypoxic–Ischemic Brain Injury)
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