Resting-state network complexity and magnitude changes in neonates with severe hypoxic ischemic encephalopathy

Hong-Xin Li; Min Yu; Ai-Bin Zheng; Qin-Fen Zhang; Guo-Wei Hua; Wen-Juan Tu; Li-Chi Zhang

doi:10.4103/1673-5374.247468

Resting-state network complexity and magnitude changes in neonates with severe hypoxic ischemic encephalopathy

Neural Regen Res. 2019 Apr;14(4):642-648. doi: 10.4103/1673-5374.247468.

Authors

Hong-Xin Li¹, Min Yu², Ai-Bin Zheng³, Qin-Fen Zhang¹, Guo-Wei Hua¹, Wen-Juan Tu¹, Li-Chi Zhang⁴

Affiliations

¹ Department of Neonatology, Changzhou Children's Hospital, Changzhou, Jiangsu Province, China.
² Graduate Student, Nantong University, Nantong, Jiangsu Province, China.
³ Department of Children's Health Research Center, Changzhou Children's Hospital, Changzhou, Jiangsu Province, China.
⁴ Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China; Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Abstract

Resting-state functional magnetic resonance imaging has revealed disrupted brain network connectivity in adults and teenagers with cerebral palsy. However, the specific brain networks implicated in neonatal cases remain poorly understood. In this study, we recruited 14 term-born infants with mild hypoxic ischemic encephalopathy and 14 term-born infants with severe hypoxic ischemic encephalopathy from Changzhou Children's Hospital, China. Resting-state functional magnetic resonance imaging data showed efficient small-world organization in whole-brain networks in both the mild and severe hypoxic ischemic encephalopathy groups. However, compared with the mild hypoxic ischemic encephalopathy group, the severe hypoxic ischemic encephalopathy group exhibited decreased local efficiency and a low clustering coefficient. The distribution of hub regions in the functional networks had fewer nodes in the severe hypoxic ischemic encephalopathy group compared with the mild hypoxic ischemic encephalopathy group. Moreover, nodal efficiency was reduced in the left rolandic operculum, left supramarginal gyrus, bilateral superior temporal gyrus, and right middle temporal gyrus. These results suggest that the topological structure of the resting state functional network in children with severe hypoxic ischemic encephalopathy is clearly distinct from that in children with mild hypoxic ischemic encephalopathy, and may be associated with impaired language, motion, and cognition. These data indicate that it may be possible to make early predictions regarding brain development in children with severe hypoxic ischemic encephalopathy, enabling early interventions targeting brain function. This study was approved by the Regional Ethics Review Boards of the Changzhou Children's Hospital (approval No. 2013-001) on January 31, 2013. Informed consent was obtained from the family members of the children. The trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800016409) and the protocol version is 1.0.

Keywords: brain functional connectivity; brain networks; clustering coefficient; hypoxic ischemic encephalopathy; local efficiency; neonates; nerve regeneration; neural regeneration; resting-state functional magnetic resonance imaging; small-world organization.