Seizures are associated with brain injury severity in a neonatal model of hypoxia-ischemia

Bjorkman, S.T., Miller, S.M, Rose, S.E., Burke, C. and Colditz, P.B. (2010) Seizures are associated with brain injury severity in a neonatal model of hypoxia-ischemia. Neuroscience, 166 1: 157-167. doi:10.1016/j.neuroscience.2009.11.067

Author Bjorkman, S.T.
Miller, S.M
Rose, S.E.
Burke, C.
Colditz, P.B.
Title Seizures are associated with brain injury severity in a neonatal model of hypoxia-ischemia
Journal name Neuroscience   Check publisher's open access policy
ISSN 0306-4522
Publication date 2010-03
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.neuroscience.2009.11.067
Volume 166
Issue 1
Start page 157
End page 167
Total pages 11
Editor O.P Ottersen
Place of publication Kiddlington, Oxford, U.K.
Publisher Pergamon
Collection year 2010
Language eng
Subject 111401 Foetal Development and Medicine
920501 Child Health
Abstract Hypoxia-ischemia is a significant cause of brain damage in the human newborn and can result in long-term neurodevelopmental disability. The loss of oxygen and glucose supply to the developing brain leads to excitotoxic neuronal cell damage and death; such over-excitation of nerve cells can also manifest as seizures. The newborn brain is highly susceptible to seizures although it is unclear what role they have in hypoxic-ischemic (H/I) injury. The aim of this study was to determine an association between seizures and severity of brain injury in a piglet model of perinatal H/I and, whether injury severity was related to type of seizure, i.e. sub-clinical (electrographic seizures only) or clinical (electrographic seizures+physical signs). Hypoxia (4% O(2)) was induced in anaesthetised newborn piglets for 30 min with a final 10 min period of hypotension; animals were recovered and survived to 72 h. Animals were monitored daily for seizures both visually and with electroencephalogram (EEG) recordings. Brain injury was assessed with magnetic resonance imaging (MRI), (1)H-MR spectroscopy ((1)H-MRS), EEG and by histology (haematoxylin and eosin). EEG seizures were observed in 75% of all H/I animals, 46% displayed clinical seizures and 29% sub-clinical seizures. Seizure animals showed significantly lower background amplitude EEG across all post-insult days. Presence of seizures was associated with lower cortical apparent diffusion coefficient (ADC) scores and changes in (1)H-MRS metabolite ratios at both 24 and 72 h post-insult. On post-mortem examination animals with seizures showed the greatest degree of neuropathological injury compared to animals without seizures. Furthermore, clinical seizure animals had significantly greater histological injury compared with sub-clinical seizure animals; this difference was not apparent on MRI or (1)H-MRS measures. In conclusion we report that both sub-clinical and clinical seizures are associated with increased severity of H/I injury in a term model of neonatal H/I.
Keyword neonatal seizures
brain damage
Hypoxia ischemia
Q-Index Code C1
Q-Index Status Confirmed Code

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