Hypoxic Ischemic Encephalopathy Clinical Trial
Official title:
Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) Biomarkers of Neonatal Hypoxic Ischemic Encephalopathy
Verified date | September 2019 |
Source | University Children's Hospital, Zurich |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Neonatal hypoxic ischemic encephalopathy (HIE) is a serious neurological condition
characterised by acute or subacute brain injury arising from perinatal hypoxia. HIE is
thought to affect approximately 0.2% of live births, and is associated with a high risk of
mortality or long-term neurological disability.
Accurate biomarkers for long-term neuro-developmental outcome following HIE are extremely
important both for clinical management and the evaluation of therapeutic approaches.
According to a recent meta-analysis, the ratio of the cerebral concentrations of lactate and
N-acetyl aspartate (NAA), two neuro-metabolites detectable with magnetic resonance
spectroscopy (MRS), currently represents the most accurate prognostic indicator of outcome
following HIE. However, for various technical reasons standard MRS methods do not offer
optimal sensitivity for detecting lactate, which may potentially be improved with a custom
lactate editing MRS sequence. In addition, while perfusion has also been suggested as a
potential biomarker for neuro-developmental outcome following HIE, due to a paucity of MR
perfusion imaging studies in neonates, the prognostic accuracy of perfusion MR measures has
not been evaluated in comparison with more established MR biomarkers. The aims of this study
are:
1. to evaluate the relative sensitivity of a custom lactate editing MRS pulse sequence
(specialist software) relative to the standard point resolved (PRESS) MRS sequence for
detecting lactate in neonates with suspected HIE.
2. to evaluate the sensitivity and specificity of MR perfusion measures in comparison to
MRS measures as predictors of neuro-developmental outcome at 2 years.
Status | Completed |
Enrollment | 59 |
Est. completion date | July 9, 2019 |
Est. primary completion date | July 9, 2019 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A to 2 Weeks |
Eligibility |
Inclusion Criteria: - Newborn infants (born at >36 weeks) with suspected perinatal asphyxia. Written informed consent from both parents. Exclusion Criteria: - Prematurity (born at < 36 weeks). Lack of written informed consent from both parents. |
Country | Name | City | State |
---|---|---|---|
Switzerland | University Children's Hospital Zurich, MRI Center | Zürich |
Lead Sponsor | Collaborator |
---|---|
University Children's Hospital, Zurich |
Switzerland,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | sensitivity of lactate editing MR spectroscopy sequence (software) relative to that of the standard MR spectroscopy sequence. | The primary end-point will be reached when lactate and perfusion data have been collected from 30 neonates. The efficacy of the custom-MRS lactate editing sequence will be assessed relative to that of the standard MRS sequence for the detection of lactate (by comparing the lactate concentration (in mM) measured from the lactate edited MR spectra to that measured from the standard MR spectra). | 12 months | |
Secondary | prognostic accuracy (sensitivity and specificity) of MRI and MRS for predicting motor outcome at age 2 | The secondary end-point will be reached upon completion of a neurological development assessment at the age of 2 years. Patients will be classified as having a good or poor outcome based on their motor skills at age 2, and the prognostic accuracy (eg sensitivity and specificity for predicting neuromotor outcome) of the standard and new MRI and MRS sequences will be assessed. | 3 years |
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