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Diffusion tensor imaging in neonatal encephalopathy: a systematic review
  1. Megan Dibble1,2,
  2. Mary Isabel O'Dea3,
  3. Tim Hurley3,
  4. Angela Byrne4,
  5. Gabrielle Colleran5,
  6. Eleanor J Molloy3,6,
  7. Arun Lawrence Warren Bokde1,2
  1. 1 Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
  2. 2 Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
  3. 3 Paediatrics and Child Health, Trinity College Dublin, Dublin, Ireland
  4. 4 Department of Radiology, Children’s Hospital Ireland (CHI) at Crumlin, Dublin, Ireland
  5. 5 Department of Radiology, The National Maternity Hospital, Dublin, Ireland
  6. 6 Department of Neonatology, Children's Hospital Ireland at Crumlin and Tallaght, Coombe Women and Infants University Hospital, Dublin, Ireland
  1. Correspondence to Megan Dibble, Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin 2, Ireland; dibblem{at}


Background and objective Diffusion tensor imaging (DTI) during the first few days of life can be used to assess brain injury in neonates with neonatal encephalopathy (NE) for outcome prediction. The goal of this review was to identify specific white matter tracts of interest that can be quantified by DTI as being altered in neonates with this condition, and to investigate its potential prognostic ability.

Methods Searches of Medline and the Cochrane Database of Systematic Reviews were conducted to identify studies with diffusion data collected in term-born neonates with NE.

Results 19 studies were included which described restricted diffusion in encephalopathic neonates as compared with healthy controls, with the posterior limb of the internal capsule and the genu and splenium of the corpus callosum identified as particular regions of interest. Restricted diffusion was related to adverse outcomes in the studies that conducted a follow-up of these infants.

Conclusions Obtaining diffusion measures in these key white matter tracts early in life before pseudonormalisation can occur can not only identify the extent of the damage but also can be used to examine the effectiveness of treatment and to predict neurodevelopmental outcome.

  • neonatal encephalopathy
  • MRI
  • diffusion weighted imaging
  • systematic review

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  • Correction notice This paper has been amended since it was published online. The article type has been changed from review to original research.

  • Contributors ALWB and EA conceived the idea for the work, MD acquired the data and performed analysis, all authors contributed to the interpretation of the data. MD and ALWB initially drafted the manuscript and all authors provided critical revisions of the work. All authors approved final version of work for submission, and agree to be accountable for all aspects of the work.

  • Funding This study was funded by Health Research Board, Ireland.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.