Improving Neurological Outcomes of HIE: Monosialoganglioside Treatment

Thus far, the most effective medical intervention for infants with hypoxic-ischemic encephalopathy (HIE) is hypothermia therapy, or cooling treatment. When administered very shortly after birth or the oxygen-depriving incident, this therapy can reverse brain damage and minimize (or in some cases prevent) permanent harm. However, hypothermia therapy is not always effective, and additional solutions for infants with hypoxic-ischemic injury are needed.

Intravenous Monosialoganglioside Treatment May Lower the Risk of Developing Cerebral Palsy and Intellectual Disabilities

Recent research in PLOS one indicates that when combined with other interventions, intravenous ganglioside treatment can improve neurological outcomes in infants with hypoxic-ischemic encephalopathy. Gangliosides are a type of lipid molecule found in neuronal membranes. They help regulate brain development and maintain the integrity of membranes. Hypoxic-ischemic injury reduces the number of certain gangliosides. Previous studies had shown some neuroprotective benefits of monosialoganglioside treatment for infants with HIE. To investigate this further, Lei Sheng and Zhaohui Li conducted a meta-analysis of studies on monosialogangliosids therapy.

Sheng and Li found that when used in conjunction with supportive treatments, monosialogangliosides reduced the risk of HIE leading to serious disabilities. The 10 studies included in this meta-analysis all administered the treatment through an IV, at a dose of 20 g per day. The duration of treatment was variable, ranging from seven to 60 days.

Infants given monosialogangliosides had a 68% lower chance of developing cerebral palsy, and a 69% lower chance of developing severe intellectual impairments. This treatment did not seem to reduce the incidence of epilepsy, although Sheng and Li note that this could be due to a lack of statistical power.

Despite overall positive results, the authors caution that their findings should be taken with a grain of salt due to methodological flaws with the studies they included. Moreover, little is known about adverse effects of this treatment; the trials included in their meta-analysis did not look into negative outcomes. Previously-reported side effects include fever, chills, cardiovascular issues, and more. The relative risks and benefits of monosialoganglioside therapy should be considered in future research.

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