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Published on: November 20, 2015
Metabolic maturation of white matter is altered in preterm infants
Stefan Blüml1, Jessica L Wisnowski2, Marvin D Nelson3
1Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California, United States of America ; Rudi Schulte Research Institute, Santa Barbara, California, United States of America.
Insights
Premature birth alters brain development, affecting key metabolites in white matter. While preterm infants initially show faster metabolic maturation, their brain development trajectories differ from full-term infants, potentially increasing neurological risks.
Area of Science:
- Neuroscience
- Developmental Biology
- Biochemistry
Background:
- Birth involves significant physiological shifts, including circulatory and environmental changes.
- These transitions may impact brain development trajectories in premature infants.
- Understanding these changes is crucial for addressing neurological risks in preterm infants.
Purpose of the Study:
- To investigate the impact of prematurity on brain metabolite concentrations.
- To compare brain development in premature and full-term infants at equivalent post-conceptional ages.
- To identify potential alterations in white matter and grey matter maturation.
Main Methods:
- Utilized in vivo magnetic resonance spectroscopy (MRS).
- Measured absolute brain metabolite concentrations (N-acetyl-aspartate, creatine, choline).
- Compared term-born and premature-born infants without brain injury at equivalent post-conceptional ages.
Main Results:
- Prematurity altered developmental trajectories of N-acetyl-aspartate, creatine, and choline in parietal white matter.
- At term-equivalency, preterm infants showed accelerated metabolic maturation, followed by slower progression.
- White matter development timing and synchronization with grey matter maturation were disturbed in preterm infants.
Conclusions:
- Prematurity disrupts the normal timing and synchronization of white matter maturation.
- Altered brain metabolite development in preterm infants may contribute to long-term neurological issues.
- These findings highlight potential risks for white matter injury in premature infants.
Abstract:
Significant physiological switches occur at birth such as the transition from fetal parallel blood flow to a two-circuit serial system with increased arterial oxygenation of blood delivered to all organs including the brain. In addition, the extra-uterine environment exposes premature infants to a host of stimuli. These events could conceivably alter the trajectory of brain development in premature infants. We used in vivo magnetic resonance spectroscopy to measure absolute brain metabolite concentrations in term and premature-born infants without evidence of brain injury at equivalent post-conceptional age. Prematurity altered the developmental time courses of N-acetyl-aspartate, a marker for axonal and neuronal development, creatine, an energy metabolite, and choline, a membrane metabolite, in parietal white matter. Specifically, at term-equivalency, metabolic maturation in preterm infants preceded development in term infants, but then progressed at a slower pace and trajectories merged at ≈340-370 post-conceptional days. In parieto/occipital grey matter similar trends were noticed but statistical significance was not reached. The timing of white matter development and synchronization of white matter and grey matter maturation in premature-born infants is disturbed. This may contribute to the greater risk of long-term neurological problems of premature infants and to their higher risk for white matter injury.
