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Publication - Dr Ela Chakkarapani

    Corpus callosal associations with cognitive and motor abilities in school-age children cooled for neonatal encephalopathy


    Geary, G, Jary, S, Tonks, J, Lee-Kelland, R, Thai, J, Brooks, J, Thoresen, M, Cowan, F & Chakkarapani, E, 2018, ‘Corpus callosal associations with cognitive and motor abilities in school-age children cooled for neonatal encephalopathy’.


    Background: Some infants cooled for neonatal encephalopathy (NE) have motor and cognitive impairments at schoolage
    despite the absence of cerebral palsy (CP). The corpus callosum (CC) carries transcallosal fibres connecting
    different cortical regions and may influence motor and cognitive function. We hypothesized that cooled children may
    have changes in the structure of the CC that is associated with their impairments.
    Objective: To compare the surface area of the CC between cooled children aged 6-8 years and controls, and
    determine associations with motor and cognitive scores.
    Design/Methods: In a case-control study, 23 cases aged 6-8 years, cooled for NE and without CP, and 20 age, sex
    and social class matched controls underwent psychometric (Wechsler Intelligence Scale for Children,WISC-IV), motor
    (Movement Assessment Battery for Children,MABC-2) and brain MRI assessments. The CC and the cross-sectional
    supratentorial brain surface area were measured manually from the mid-sagittal T1 mprage image. The CC was
    segmented into three equal parts: frontal, mid and occipital. We further divided the mid segment into anterior 1/3rd
    and posterior 2/3rds, as the posterior 2/3rds carry motor fibres.(Fig 1)
    Results: All cases had a normally appearing CC on neonatal MRI. No focal lesions were seen on the childhood MRI.
    Cases, compared to controls, had significantly smaller total CC, frontal, occipital and anterior 1/3rd of mid CC segment
    areas, but a comparable area of the posterior 2/3rds of the mid segment. (Table 1) Controlling for cross-sectional
    brain area, sex and age, cases had a significantly smaller anterior 1/3rd of mid CC (β= -0.07cm2 (95% CI: -0.11, -
    0.02). On multiple linear regression significant independent predictors were: total CC area for verbal comprehension
    and processing speed; case and male sex for perceptual reasoning; occipital segment area for working memory; total
    CC area and case for full-scale IQ. No association was found between CC areas and motor function.(Table 2)
    Conclusion(s): In the cooled children without CP, the anterior 1/3 of the mid CC segment was smaller, but the
    posterior segment was of normal size compared to matched controls. WISC-IV subscale scores but not MABC-2
    subscale scores were associated with CC size, suggesting that the development of CC influenced cognitive function.

    Full details in the University publications repository