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Abstract #1151

Early MRS biomarkers accurately predict neurodevelopment after neonatal encephalopathy in a multicentre setting

Peter J Lally1,2, Paolo Montaldo1,2, Vânia Oliveira1,2, Ravi Swamy1,2, Gaurav Atreja1,2, Josephine Mendoza1,2, Alan Bainbridge3, David Price3, Aung Soe4, Seetha Shankaran5, and Sudhin Thayyil1,2

1Centre for Perinatal Neuroscience, Imperial College London, London, United Kingdom, 2Imperial College Healthcare NHS Trust, London, United Kingdom, 3Medical Physics and Bioengineering, University College London Hospitals NHS Trust, London, United Kingdom, 4Medway NHS Foundation Trust, Kent, United Kingdom, 5Department of Neonatology, Children's Hospital of Michigan, Detroit, MI, United States

In neuroprotection trials for neonatal encephalopathy, the typical clinical outcome measures can only be measured reliably after a period of years. In a multicentre study covering eight sites and recruiting 224 infants, we demonstrate that MRS measures made within two weeks of birth provide quantitative and objective tools for predicting neurodevelopmental abnormalities usually only observed years after the initial injury. In particular, the thalamic concentration of tNAA (N-acetyl aspartate + N-acetyl aspartyl glutamate) has an area under the receiver operating characteristic curve of 0.99 (95%CI 0.98–1.00, n=82). Such tools could greatly speed up the next generation of clinical trials.

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