Objective In contrast to motor impairments, the association between lesion location and cognitive or language deficits in patients with neonatal arterial ischaemic stroke remains largely unknown. We conducted a voxel-based lesion-symptom mapping cross-sectional study aiming to reveal neonatal arterial stroke location correlates of language, motor and cognitive outcomes at 2 years of age.
Design Prospective observational multicentre study.
Setting Six paediatric university hospitals in Spain.
Participants We included 53 patients who had a neonatal arterial ischaemic stroke with neonatal MRI and who were followed up till 2 years of age.
Main outcome measures We analysed five dichotomous clinical variables: speech therapy (defined as the need for speech therapy as established by therapists), gross motor function impairment, and the language, motor and cognitive Bayley scales. All the analyses were controlled for total lesion volume.
Results We found that three of the clinical variables analysed significantly correlated with neonatal stroke location. Speech therapy was associated with lesions located mainly at the left supramarginal gyrus (p=0.007), gross motor function impairment correlated with lesions at the left external capsule (p=0.044) and cognitive impairment was associated with frontal lesions, particularly located at the left inferior and middle frontal gyri (p=0.012).
Conclusions The identification of these susceptible brain areas will allow for more precise prediction of neurological impairments on the basis of neonatal brain MRI.
Data availability statement
All data used in this study are available upon reasonable request.
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CN and CS-O are joint first authors.
Contributors CS and AG contributed to the conception and design of the study. CN, CS, and GA analysed the data. All authors contributed to drafting the manuscript and the figures.
Funding This work was supported by Grant PI15/00846 from the Instituto de Salud Carlos III co-funded by the European Regional Development Fund, and by a 'Beca Bombers' award from the Fundació Sant Joan de Déu.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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