Correlation of resting-state brain network changes with behavioral neurological measures in neonatal hypoxic-ischemic encephalopathy
Objective To investigate the correlation between resting-state brain network alterations and behavioral neurometry in neonates with hypoxic-ischemic encephalopathy(HIE).Method 230 newborns with HIE admitted to Hainan Women and Children Medical Center from May 2019 to October 2022 were selected as the study subjects,and they were divided into neurobehavioral disorder(ND)group(n=68)and non-ND group(n=162)according to the results of neonatal behavioral neurological assessment(NBNA)scores.Comparing the amplitude of low frequency(ALFF)values in different brain regions between the two groups,multifactorial logistic regression was used to analyze the factors influencing the occurrence of ND in children with HIE;the predictive value of global attribute index parameters for the occurrence of ND in children with HIE was analyzed by using receiver operating characteristic(ROC)curves.Results The ALFF values of the anterior temporal lobe,middle temporal lobe,anterior cingulate gyrus,middle cingulate gyrus,posterior cingulate gyrus,medial prefrontal cortex,inferior frontal gyrus,orbital frontal cortex,parahippocampal cortex,nucleus accumbens,and the pallidum in the brain regions of the ND group were lower than those of the non-ND group,whereas ALFF values of the anterior cuneate lobe and the talar fissure cortical brain regions were higher than those of the non-ND group,and the differences were statistically significant(t=2.065-4.897,respectively,P＜0.05).Multifactorial logistic regression analysis showed that preterm birth,HIE score(severe),and intrauterine distress were independent risk factors for the development of ND in children with HIE,with ORs and 95％CIs of 2.217(1.377-2.983),1.635(1.224-2.358),and 1.492(1.039-1.875),respectively;birth 5min Apgar score,birth weight,local efficiency(Eloc),and clustering coefficient(Cp)were protective factors for the occurrence of ND in children with HIE,with ORs and 95％CIs of 0.864(0.418-0.902),0.846(0.313-0.961),0.753(0.255-0.884),0.548(0.374-0.923).ROC curve analysis results showed that the area under the curve(AUC)of Eloc,Cp and normalized shortest path length(λ)were 0.803(0.768-0.871),0.782(0.724-0.838),0.769(0.683-0.815)and 0.815(0.773-0.896)respectively.The performance of combined prediction was better than that of predicting severe brain injury as a diagnostic index alone.Conclusion Newborns with HIE with combined ND had changes in ALFF values in various brain regions of the resting state brain network,and the global attribute index parameters Eloc and Cp were significantly reduced.
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