ASL reveals regional brain perfusion impairment in neonates with mild hypoxic ischemic encephalopathy
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Published version
Author(s)
Type
Journal Article
Abstract
There is a lack of neuroimaging data and effective biomarkers in infants with mild hypoxic ischaemic encephalopathy (HIE). Cerebral reperfusion injury has shown potential as marker of neurodevelopmental outcome in moderate and severe HIE. We examined cerebral perfusion by using arterial spin labelling (ASL) in infants with mild HIE and its associations with adverse outcomes. We also studied the presence of any potential regional sensitivity of cerebral blood flow (CBF) on the effects of HIE severity. This prospective cohort study included term and near-term neonates admitted for HIE across 3 neonatal intensive care units in Italy between October 2019–2022. Magnetic resonance imaging (MRI)-ASL was performed between 4 and 10 days after birth. Neurodevelopmental outcome was assessed at 24–28 months. Of the 94 infants included in the analysis, 74 neonates had mild [79%], 15 moderate [16%], 5 severe encephalopathy [5%]. Of the 71 neonates with mild HIE and neurodevelopmental outcome available, 15 (21%) showed mild disability. Basal ganglia CBF was the only region significantly associated with cognitive, motor and language Bayley scores (false-discovery-rate < 0.05). HIE severity had a regional dependent effect with involvement of Heschl, Rolandic operculum, limbic lobe, subcortical gray nuclei followed by frontal lobes. Basal ganglia CBF in infants with mild HIE was associated with adverse outcomes even without any MRI visible deep brain nuclei injury.
Date Issued
2025-08-28
Date Acceptance
2025-08-22
Citation
Scientific Reports, 2025, 15
ISSN
2045-2322
Publisher
Nature Portfolio
Journal / Book Title
Scientific Reports
Volume
15
Copyright Statement
© The Author(s) 2025 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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Publication Status
Published
Article Number
31676
Date Publish Online
2025-08-28