The following is a summary of “Plasma Biomarkers of Evolving Encephalopathy and Brain Injury in Neonates with Hypoxic-Ischemic Encephalopathy,” published in the JANUARY 2023 issue of Pediatrics by Li, et al.

For a study, researchers sought to investigate the correlation between a group of potential plasma biomarkers and two aspects of evolving encephalopathy in neonates with moderate-to-severe hypoxic-ischemic encephalopathy (HIE): death or severe brain injury on MRI, and impaired cerebral pressure autoregulation. 

The patients received therapeutic hypothermia (TH) and were continuously monitored using blood pressure and near-infrared spectroscopy. The hemoglobin volume phase (HVP) index was used to assess cerebral pressure autoregulation, and Tau, glial fibrillary acidic protein, and neurogranin were measured in serial blood samples. The MRI results were evaluated using National Institutes of Child Health and Human Development scores. The relationships between the candidate biomarkers and death or severe brain injury on MRI (defined as a National Institutes of Child Health and Human Development score of ≥ 2B) and autoregulation were analyzed using bivariate and adjusted logistic regression models. 

The findings showed that 62 patients had elevated Tau levels on days 2-3 of TH, which was linked to death or severe injury on MRI (aOR: 1.06, 95% CI: 1.03-1.09; aOR: 1.04, 95% CI: 1.01-1.06, respectively). Additionally, higher Tau levels were linked to poorer autoregulation (higher HVP index) on the same day (P = .022). 

The study concluded that high levels of Tau in plasma were associated with death or severe brain injury on MRI and impaired cerebral pressure autoregulation in neonates with HIE, necessitating further extensive research to validate Tau as a biomarker of brain injury in neonates with HIE.

Reference: jpeds.com/article/S0022-3476(22)00675-8/fulltext