{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:16:34Z","timestamp":1791562594570,"version":"4.3.4"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The objective of this study is to determine the predictive value of magnetic resonance imaging (MRI), amplitude-integrated electroencephalography (aEEG), the Hammersmith Neonatal Neurological Examination (HNNE), and the General Movements Assessment (GMA) for cerebral palsy (CP) in neonates with hypoxic\u2013ischemic encephalopathy (HIE), and to evaluate whether combining these modalities improves diagnostic accuracy.<\/jats:p>\n                  <jats:p>In this prospective two-center cohort study, 53 term or late-preterm infants with HIE treated with standardized therapeutic hypothermia (33.5\u00b0C for 72\u2009hours) were evaluated. aEEG and MRI findings were compared with concurrent HNNE and GMA results. CP was diagnosed during follow-up by a pediatric neurologist blinded to neonatal data. Diagnostic performance was analyzed using receiver-operating characteristic curves and multivariable logistic regression according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.<\/jats:p>\n                  <jats:p>CP developed in 11 infants (20.8%). aEEG showed the highest predictive accuracy (area under the curve\u2009=\u20090.816 [95% confidence interval: 0.65\u20130.98]), and abnormal aEEG independently predicted CP (odds ratio\u2009=\u200918.5, p\u2009=\u20090.004). The combined \u201cMRI or aEEG abnormal\u201d model achieved the best overall accuracy (86.8%), with sensitivity\u2009=\u200990.9% and negative predictive value\u2009=\u200997.3%. MRI and HNNE had moderate predictive value, whereas GMA showed high specificity but low sensitivity.<\/jats:p>\n                  <jats:p>aEEG emerged as a robust and independent early biomarker for CP prediction after HIE. Combining aEEG with MRI substantially enhanced diagnostic precision, reflecting complementary functional and structural brain injury mechanisms. Although HNNE and GMA add screening value, they are insufficient alone. Standardized multimodal protocols integrating structural (MRI), functional (aEEG), and clinical (HNNE\u2013GMA) assessments should be incorporated into clinical practice to improve early prognostication and guide neuroprotective interventions.<\/jats:p>","DOI":"10.1055\/a-2826-4512","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T23:53:59Z","timestamp":1772841239000},"page":"1767-1774","source":"Crossref","is-referenced-by-count":1,"title":["Early Multimodal Assessment for Prediction of Cerebral Palsy in Neonatal Hypoxic\u2013Ischemic Encephalopathy"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5015-621X","authenticated-orcid":false,"given":"Fatih","family":"Isleyen","sequence":"additional","affiliation":[{"name":"Department of Neonatology, \u015eanl\u0131urfa Training and Research Hospital, \u015eanl\u0131urfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canan","family":"Kocaman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology, Okan University Faculty of Medicine, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4041-0648","authenticated-orcid":false,"given":"Asli Okbay","family":"Gunes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, University of Health Sciences, Sancaktepe Prof. Dr. \u0130lhan Varank Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Fatih","family":"Deveci","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Harran University Faculty of Medicine, \u015eanl\u0131urfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celil","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology, Alanya Training and Research Hospital, Antalya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arzu","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Florence Nightingale Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gazanfer","family":"Ekinci","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yeditepe University Faculty of Medicine, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ipek","family":"Akman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Maltepe University Faculty of Medicine, Istanbul, 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