Multimodal neuro-assessment after adverse neonatal events in the context of prematurity and perinatal asphyxia with encephalopathy

Sometimes birth does not go as planned, and various complications could be responsible for perinatal brain damages and cause adverse long-term neurodevelopmental sequelae.

In the first part of my thesis project, the research topic is the long-term consequences of very preterm birth. While survival rate has increased these last decades, prematurely born schoolchildren are still more likely to show long-term neurodevelopmental cognitive impairments and neuropsychiatric disorders. In this section, we investigate, in a cohort of former very preterm neonates who were followed since their birth, brain functions at the age of 8-9 years, using a comprehensive multimodal approach combining MRI, and neuropsychological assessments.

In the second part, the focus is on perinatal asphyxia. The objective is to explore brain integrity and function in neonates and children without overt brain injury and disability following neonatal encephalopathy, using the same type of multimodal neuro-assessment with brain MRI, high-density EEG, and neuropsychological assessments as well as echocardiography. Indeed, perinatal asphyxia is still a major cause of neonatal death, and even in cases of survival it can lead to adverse long-term neurological outcomes (e.g., cerebral palsy, epilepsy, mental retardation, learning and/or behavioral disorders). Nowadays, therapeutic hypothermia as a neuroprotective treatment has increased the rate of survival without overt disability. However, the brain structure and function of these neonates are not yet characterized thoroughly. Additionally, there is too little information on the consequences of neonatal encephalopathy on school-aged children. Therefore, on the one hand, we study a population of neonates with neonatal encephalopathy with the objective to compare their brain structure and function to those of term controls. On the other hand, we investigate children at 6 years of age who were admitted for neonatal encephalopathy during the neonatal period to assess their detailed neuropsychological phenotype at school age together with a new MRI and EEG, according to their initial brain MRI lesions.

Collectively, my thesis will contribute to improve our understanding to allow a better prognostication and individualization of follow-up and support for the parents and children