Developing a framework for studying brain networks in neonatal hypoxic-ischemic encephalopathy

Abstract

Newborns with hypoxic-ischemic encephalopathy (HIE) are at high risk of brain injury, with subsequent developmental problems including severe neuromotor, cognitive and behavioral impairment. Neural correlates of cognitive and behavioral impairment in neonatal HIE, in particular in infants who survive without severe neuromotor impairment, are poorly understood. It is reasonable to hypothesize that in HIE both structural and functional brain networks are altered, and that this might be the neural correlate of impaired cognitive and/or behavioral impairment in HIE. Here, an analysis pipeline to study the structural and functional brain networks from neonatal MRI in newborns with HIE is presented. The structural connectivity is generated from dense whole-brain tractograms derived from diffusion-weighted MR fibre tractography. This investigation of functional connectivity focuses on the emerging resting state networks (RSNs), which are sensitive to injuries from hypoxic-ischemic insults to the newborn brain. In conjunction with the structural connectivity, alterations to the structuro-functional connectivity of the RSNs can be studied. Preliminary results from a proof-of-concept study in a small cohort of newborns with HIE are promising. The obstacles encountered and improvements to the pipeline are discussed. The framework can be further extended for joint analysis with EEG functional-connectivity.

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