Acute sentinel hypoxia-ischaemia in neonates can target the hippocampus, mammillary bodies, thalamus, and the basal ganglia. Our previous work with paediatric patients with a history of hypoxia-ischaemia has revealed hippocampal and diencephalic damage that impacts cognitive memory. However, the structural and functional status of other brain regions vulnerable to hypoxia-ischaemia, such as the basal ganglia, has not been investigated in these patients. Furthermore, it is not known whether there are any behavioural sequelae of such damage, especially in patients with no diagnosis of neurological disorder. Based on the established role of the basal ganglia and the thalamus in movement coordination, we studied manual motor function in 20 participants exposed to neonatal hypoxia-ischaemia, and a group of 17 healthy controls of comparable age. The patients’ handwriting speed and accuracy was within the normal range (Detailed Assessment of Speed of Handwriting), and their movement adaptation learning (Rotary Pursuit task) was comparable to the control group’s performance. However, as a group, patients showed an impairment in the Grooved Pegboard task and a trend for impairment in speed of movement while performing the Rotary Pursuit task, suggesting that some patients have subtle deficits in fine, complex hand movements. Voxel-based morphometry and volumetry showed bilateral reduction in grey matter volume of the thalamus and caudate nucleus. Reduced volumes in the caudate nucleus correlated across patients with performance on the Grooved Pegboard task. In summary, the fine movement coordination deficit affecting the hand and the wrist in patients exposed to early hypoxic-ischaemic brain injury may be related to reduced volumes of the caudate nucleus, and consistent with anecdotal parental reports of clumsiness and coordination difficulties in this cohort.

新生儿急性前哨缺氧缺血可针对海马体、乳头体、丘脑和基底神经节。我们之前对有缺氧缺血病史的儿科患者的研究表明，海马和间脑损伤会影响认知记忆。然而，其他易受缺氧缺血影响的大脑区域（例如基底神经节）的结构和功能状态尚未在这些患者中进行研究。此外，尚不清楚这种损害是否会产生任何行为后遗症，特别是对于未诊断出神经系统疾病的患者。基于基底神经节和丘脑在运动协调中的既定作用，我们研究了 20 名暴露于新生儿缺氧缺血的参与者和一组 17 名年龄相当的健康对照者的手动运动功能。患者的书写速度和准确性在正常范围内（手写速度详细评估），并且他们的运动适应学习（旋转追踪任务）与对照组的表现相当。然而，作为一个群体，患者在凹槽钉板任务中表现出受损，并且在执行旋转追踪任务时运动速度有受损的趋势，这表明一些患者在精细、复杂的手部动作方面存在细微的缺陷。基于体素的形态测量和体积测量显示丘脑和尾状核的双侧灰质体积减少。患者尾状核体积的减少与凹槽钉板任务的表现相关。总之，早期缺氧缺血性脑损伤患者的手和腕部的精细运动协调缺陷可能与尾状核体积减少有关，并且与该队列中家长关于笨拙和协调困难的轶事报道一致。