Prediction of long-term neurodevelopmental delay using cerebral oxygen extraction fraction in neonates with hypoxic ischemic encephalopathy

Motivation: About half of the neonates with Hypoxic-ischemic-encephalopathy (HIE) have poor long-term neurodevelopmental outcomes, so biomarkers predicting long-term outcomes are needed. Oxygen extraction fraction (OEF) in the brain is sensitive in detecting HIE abnormalities at the neonatal stage. Goal(s): To evaluate if OEF can predict long-term neurodevelopment delay in neonates with HIE. Approach: The global OEF was measured non-invasively by TRUST MRI in 14 neonates with HIE at 1 week old. Their neurodevelopmental status was assessed at 5-9 and 12-20 months, respectively. Results: A significant association was observed between neonatal OEF and neurodevelopment status. Lower OEF was associated with delayed neurodevelopment after 12 months. Impact: This study demonstrated that global OEF, measured by TRUST MRI non-invasively in 1.2 minutes, can be an effective biomarker for predicting long-term neurodevelopmental outcomes in neonates with HIE, assisting clinical decisions on early initiation of adequate therapies.