Imperial College London
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Dr Peter J Lally

Faculty of Engineering, Department of Bioengineering

Sir Henry Wellcome Fellow and Proleptic Lecturer
 
 
 
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p.lally

 
 
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Location

 

511ASir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Montaldo:2020:10.1016/j.ebiom.2020.102663,
author = {Montaldo, P and Ivain, P and Lally, P and Bassett, P and Pant, S and Oliveira, V and Mendoza, J and Morales, M and Swamy, R and Shankaran, S and Thayyil, S},
doi = {10.1016/j.ebiom.2020.102663},
journal = {EBioMedicine},
title = {White matter injury after neonatal encephalopathy is associated with thalamic metabolite perturbations},
url = {http://dx.doi.org/10.1016/j.ebiom.2020.102663},
volume = {52},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundAlthough thalamic magnetic resonance (MR) spectroscopy (MRS) accurately predicts adverse outcomes after neonatal encephalopathy, its utility in infants without MR visible deep brain nuclei injury is not known. We examined thalamic MRS metabolite perturbations in encephalopathic infants with white matter (WM) injury with or without cortical injury and its associations with adverse outcomes.MethodsWe performed a subgroup analysis of all infants recruited to the MARBLE study with isolated WM or mixed WM/cortical injury, but no visible injury to the basal ganglia/thalamus (BGT) or posterior limb of the internal capsule (PLIC). We used binary logistic regression to examine the association of MRS biomarkers with three outcomes (i) WM injury score (1 vs. 2/3); (ii) cortical injury scores (0/1 vs. 2/3); and (iii) adverse outcomes (defined as death, moderate/severe disability) at two years (yes/no). We also assessed the accuracy of MRS for predicting adverse outcome.FindingsOf the 107 infants included in the analysis, five had adverse outcome. Reduced thalamic N-acetylaspartate concentration [NAA] (odds ratio 0.4 (95% CI 0.18–0.93)) and elevated thalamic Lactate/NAA peak area ratio (odds ratio 3.37 (95% CI 1.45–7.82)) were significantly associated with higher WM injury scores, but not with cortical injury. Thalamic [NAA] (≤5.6 mmol/kg/wet weight) had the best accuracy for predicting adverse outcomes (sensitivity 1.00 (95% CI 0.16–1.00); specificity 0.95 (95% CI 0.84–0.99)).InterpretationThalamic NAA is reduced in encephalopathic infants without MR visible deep brain nuclei injury and may be a useful predictor of adverse outcomes.FundingThe National Institute for Health Research (NIHR).
AU  - Montaldo,P
AU  - Ivain,P
AU  - Lally,P
AU  - Bassett,P
AU  - Pant,S
AU  - Oliveira,V
AU  - Mendoza,J
AU  - Morales,M
AU  - Swamy,R
AU  - Shankaran,S
AU  - Thayyil,S
DO  - 10.1016/j.ebiom.2020.102663
PY  - 2020///
SN  - 2352-3964
TI  - White matter injury after neonatal encephalopathy is associated with thalamic metabolite perturbations
T2  - EBioMedicine
UR  - http://dx.doi.org/10.1016/j.ebiom.2020.102663
UR  - http://hdl.handle.net/10044/1/77309
VL  - 52
ER  -
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