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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doaj-237af92295764c7e9e5f1af70cee05a42021-10-03T04:40:07ZengElsevierNeuroImage: Clinical2213-15822021-01-0132102835Hyperglycemia associated with acute brain injury in neonatal encephalopathyEmily W.Y. Tam0Daphne Kamino1Anwar S. Shatil2Vann Chau3Aideen M. Moore4Rollin Brant5Elysa Widjaja6Department of Paediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada; Corresponding author at: Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada.Neurosciences and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, CanadaNeurosciences and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, CanadaDepartment of Paediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, ON, CanadaDepartment of Paediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, ON, CanadaDepartment of Statistics, The University of British Columbia, Vancouver, BC, CanadaDepartment of Paediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health Program, Hospital for Sick Children Research Institute, Toronto, ON, Canada; Department of Radiology, The Hospital for Sick Children and the University of Toronto, Toronto, ON, CanadaObjective: 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.http://www.sciencedirect.com/science/article/pii/S2213158221002795HypoglycemiaHyperglycemiaNeonatal encephalopathyDiffusion tensor imaging |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Emily W.Y. Tam Daphne Kamino Anwar S. Shatil Vann Chau Aideen M. Moore Rollin Brant Elysa Widjaja |
spellingShingle |
Emily W.Y. Tam Daphne Kamino Anwar S. Shatil Vann Chau Aideen M. Moore Rollin Brant Elysa Widjaja Hyperglycemia associated with acute brain injury in neonatal encephalopathy NeuroImage: Clinical Hypoglycemia Hyperglycemia Neonatal encephalopathy Diffusion tensor imaging |
author_facet |
Emily W.Y. Tam Daphne Kamino Anwar S. Shatil Vann Chau Aideen M. Moore Rollin Brant Elysa Widjaja |
author_sort |
Emily W.Y. Tam |
title |
Hyperglycemia associated with acute brain injury in neonatal encephalopathy |
title_short |
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_sort |
hyperglycemia associated with acute brain injury in neonatal encephalopathy |
publisher |
Elsevier |
series |
NeuroImage: Clinical |
issn |
2213-1582 |
publishDate |
2021-01-01 |
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. |
topic |
Hypoglycemia Hyperglycemia Neonatal encephalopathy Diffusion tensor imaging |
url |
http://www.sciencedirect.com/science/article/pii/S2213158221002795 |
work_keys_str_mv |
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