MRI scores predict cognitive development in babies with neonatal encephalopathy

Existing magnetic resonance imaging (MRI) scoring systems can reliably predict cognitive and motor outcomes at 2 years in term infants with neonatal encephalopathy (NE), a new study has found.

The study included 135 infants of whom 90 underwent MRI and 66 (median age at MRI scan 7 days, 68 percent boys) returned for follow-up. MRI scores assessed included the Barkovich, Weeke, and NICHD NRN*. Neurodevelopment was evaluated at age 2 years using the Bayley-III inventory.

Taking into consideration both baseline and follow-up assessments, the Weeke score detected MRI abnormalities with the greatest frequency (77 percent), followed by the NICHD NRN (50 percent) and Barkovich (40 percent) scores.

In terms of neurodevelopmental outcomes, nine cases (14 percent) of cognitive impairment were detected, five of which were mild and four were severe. Language impairment was detected in 10 infants (16 percent), while motor impairment was observed in seven infants (11 percent).

The Barkovich (adjusted R², 0.1269; p=0.0102), NICHD NRN (adjusted R², 0.2236; p=0.0026), and Weeke (adjusted R²; p<0.0001) scores were all significantly correlated with Bayley-III cognitive scores. In terms of language, only the Weeke score proved to be a significant correlate (adjusted R², 0.1747; p=0.0022).

Bayley-III motor scores were likewise significantly associated with all three MRI scores: Barkovich (adjusted R², 0.1053; p=0.0204), NICHD NRN (adjusted R², 0.2703; p=0.0006), and Weeke (adjusted R², 0.3018; p<0.0001).

“We confirm the predictive value of existing MRI scoring systems for cognitive and motor outcomes, and show that more detailed scoring systems have added prognostic value for language outcome. Future studies should examine how generalizable these findings are to infants with varied severity levels of NE,” the researchers said.

* National Institute of Child Health and Human Development Neonatal Research Network