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. 2022 Oct 22;12(1):17757.
doi: 10.1038/s41598-022-21723-1.

Communication skills in children aged 6-8 years, without cerebral palsy cooled for neonatal hypoxic-ischemic encephalopathy

Thomas J Robb  1 , James Tonks  2   3 , Arthur P C Spencer  2 , Sally Jary  2 , Charlotte K Whitfield  3 , Marianne Thoresen  2   4 , Frances M Cowan  2 , Ela Chakkarapani  5   6
Affiliations

Communication skills in children aged 6-8 years, without cerebral palsy cooled for neonatal hypoxic-ischemic encephalopathy

Thomas J Robb et al. Sci Rep. .

Abstract

We assessed communication skills of 48 children without cerebral palsy (CP) treated with therapeutic hypothermia (TH) for neonatal hypoxic-ischemic encephalopathy (HIE) (cases) compared to 42 controls at early school-age and examined their association with white matter diffusion properties in both groups and 18-month Bayley-III developmental assessments in cases. Parents completed a Children's Communication Checklist (CCC-2) yielding a General Communication Composite (GCC), structural and pragmatic language scores and autistic-type behavior score. GCC ≤ 54 and thresholds of structural and pragmatic language score differences defined language impairment. Using tract-based spatial statistics (TBSS), fractional anisotropy (FA) was compared between 31 cases and 35 controls. Compared to controls, cases had lower GCC (p = 0.02), structural (p = 0.03) and pragmatic language score (p = 0.04) and higher language impairments (p = 0.03). GCC correlated with FA in the mid-body of the corpus callosum, the cingulum and the superior longitudinal fasciculus (p < 0.05) in cases. Bayley-III Language Composite correlated with GCC (r = 0.34, p = 0.017), structural (r = 0.34, p = 0.02) and pragmatic (r = 0.32, p = 0.03) language scores and autistic-type behaviors (r = 0.36, p = 0.01).

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study recruitment flowchart indicating exclusion criteria at each stage of recruitment, and subsequent N number of participants included in analyses of: GCC case–control comparison, Fractional anisotropy and GCC correlation in cases and in controls, and Bayley-III–GCC correlation in cases. For MRI analysis, participants were excluded who did not undergo MRI, or where significant movement artefact was present.
Figure 2
Figure 2
Comparison of mean General Communication Composite score in control (gray) and case (orange) children.
Figure 3
Figure 3
Comparison of structural language scores (a), pragmatic language scores (b) and autistic type behaviors (c) between control (gray) and case (orange) children.
Figure 4
Figure 4
TBSS results showing areas of white matter which exhibit correlation between FA and GCC score in cases, independent of age sex and deprivation index (p < 0.05, TFCE-corrected). No significant correlations were found in controls. The white matter skeleton is shown in green with significance of positive correlations indicated by the colour bar. These are overlaid on the MNI standard template with the position of the slice in MNI space given under each slice. Labels indicate some major white matter tracts and regions. ATR anterior thalamic radiation, CC corpus callosum, EC external capsule, FMajor forceps major, FMinor forceps minor, IC internal capsule, IFOF inferior fronto-occipital fasciculus, ILF inferior longitudinal fasciculus, SLF superior longitudinal fasciculus.
Figure 5
Figure 5
Comparison of Bayley-III Language Composite scores and GCC (a); structural language (c); pragmatic language (e). Comparison of Bayley-III Cognitive Composite scores and GCC (b); structural language (d); pragmatic language (f). The Y-axis dashed line in figure (a) and (b) represents GCC = 54 (10th centile of the UK standardised cohort). The X-axis dashed line in figure (a) and (b) represents Bayley-III Composite score = 85 (1 SD below the normative mean).
Figure 6
Figure 6
Comparison of autistic-type behaviors scores and Bayley-III Language (a) and Cognitive (b) Composite scores.
See this image and copyright information in PMC

References

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