Kim Annink

130 Chapter 6 Table 5: Continued Outcome measure Model with MB Odds ratio (95%CI) Model with hippocampus Odds ratio (95%CI) Visual-spatial long-term memory direct recall MB atrophy n/a a Hippocampus 0.33 (0.14-0.77) Visual-spatial long-term memory delayed recall MB atrophy n/a a Hippocampus 0.21 (0.07-0.63) a No Odds Ratio’s could be calculated, because none of the infants with atrophy of the MB had a normal outcome. MRI – TBSS Given the observed association between the hippocampal volume and MB atrophy and neuropsychological outcome, these parameters were used for TBSS. TBSS analyses showed that normal MB and larger hippocampal volumes, corrected for age and sex, had a wide spread positive effect on FA-values throughout the brain. For the neurodevelopmental measures, only PIQ and visual-spatial long-term memory delayed recall were significantly associated with FA values in the TBSS analyses. Age and sex were not associated with FA in any of the analyses. See Figure 3. DISCUSSION This study shows that children at 10 years of age with a history of HIE due to presumed perinatal asphyxia have long-term neurodevelopmental problems. This also applied to children who were treated with therapeutic hypothermia. Parts of the Papez circuit, i.e. hippocampal volumes and atrophy of the MB, were strongly associated with especially cognitive and memory problems. Furthermore, hippocampal volumes were significantly smaller in children with MB atrophy compared to normal MB. Even after correction for grey matter, white matter, cerebellar and lateral ventricle volumes, hippocampal volume and MB atrophy remained significantly associated with IQ measures, verbal long-term memory and visual-spatial long-termmemory. Finally, children with normal MB or larger hippocampal volumes had significantly higher FA values throughout the white matter. We were able to show that the volumes of different brain structures were associated with neurocognitive and memory outcomes at 10 years of age. However, after correction for multiple comparisons, only hippocampal volume and MB atrophy were strongly