Kim Annink

21 General introduction OUTLINE OF THIS THESIS In part I, different imaging modalities in infants with HIE and the long-term outcome of children with HIE following perinatal asphyxia are investigated. Part II describes the current literature on neuroprotection with allopurinol and the study protocol and pharmacokinetic results of the ALBINO trial. Part III of this thesis investigates and discusses the feasibility of innovative neuroimaging techniques. Part I: neuroimaging and follow-up Chapter two describes a specific pattern of cerebellar injury in infants with HIE. Chapter three shows the correlation of cerebellar injury in infants with HIE based on DWI versus histopathology. In chapter four, the development and validation of a new CUS scoring method is described. Chapter five discusses the association between HIE, hippocampal volumes at ten years of age and cognitive outcome in a cohort of children born in the “precooling” era. Chapter six shows the results of a prospective observational cohort study in which we assessed neuropsychological, motor and MRI exams at ten years of age in children that were cooled and children that were born before the cooling era. Part II: add-on neuroprotection Chapter seven provides an overview of all literature on allopurinol as neuroprotective agent in neonates with HIE. Chapter eight describes the study protocol of a large ongoing randomized controlled trial (ALBINO), investigating the neuroprotective effect of allopurinol administered during resuscitation in neonates with HIE. Chapter nine shows the first results of the ALBINO trial: the pharmacokinetics of allopurinol during therapeutic hypothermia. Part III: innovative neuroimaging techniques Chapter ten describes a new method to reliably and non-invasively measure brain temperature in infants with HIE using magnetic resonance spectroscopy. Chapter eleven discusses the safety preparations and feasibility of 7.0T MRI in infants and shows the first 7.0T images. Finally, chapter twelve summarizes the findings of this thesis and discusses the implications and future directions for research in this field. Chapter thirteen summarizes the results of this thesis in Dutch. 1