Abstract #4110

Deep grey matter brain alkalosis in neonatal encephalopathy measured using 31P ISIS is associated with seizure burden and poor outcomes

David Price¹, Cristina Uria-Avellanal ², Magdalena Sokolska¹, Subhabrata Mitra², Alan Bainbridge¹, Xavier Golay³, and Nicola Robertson⁴

¹Medical Physics and Biomedical Engineering, UCLH NHS Trust, London, United Kingdom, ²Neonatology, UCLH NHS Trust, London, United Kingdom, ³Institute of Neurology, University College London, ⁴Institute for Women's Health, University College London

31P image selected in vivo spectroscopy was used to measure deep grey matter intracellular pH in 43 neonates with hypoxic-ischaemic encephalopathy. All neonates had previously received therapeutic hypothermia, the current standard of care. Brain alkalosis was associated with poor outcomes reproducing what was found from whole-brain pH measurements in the pre-cooling era. Brain alkalosis was associated with increased seizure burden, the first time this has been shown in babies. Avoiding brain alkalosis could be a new objective for treating seizures and for neuroprotection in neonatal encephalopathy.

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