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Magnetic resonance spectroscopy at term-equivalent age in extremely preterm infants: association with cognitive and
Roopali Bapat1, Ponnada A Narayana2, Yuxiang Zhou2
1Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital and The Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
Insights
Extremely low birth weight infants show altered brain metabolite ratios at term-equivalent age. These magnetic resonance spectroscopy (MRS) findings correlate with cognitive and language development at 18-22 months corrected age.
Area of Science:
- Neuroscience
- Pediatrics
- Medical Imaging
Background:
- Proton magnetic resonance spectroscopy (MRS) is a valuable tool for assessing brain development and integrity.
- Understanding brain maturation in preterm infants is crucial for predicting long-term outcomes.
Purpose of the Study:
- To compare cerebral MRS metabolite ratios between extremely low birth weight (ELBW) infants and healthy term controls at term-equivalent age.
- To investigate the association between MRS metabolites and neurodevelopmental outcomes at 18-22 months corrected age in ELBW infants.
Main Methods:
- A prospective cohort study involving 43 infants (31 ELBW, 12 controls).
- Single-voxel point-resolved spectroscopy was used to measure MRS metabolite ratios (NAA/Cho, NAA/mIns) in the hippocampus, cortex, and subventricular zone.
- Neurodevelopmental assessment using Bayley Scales at 18-22 months corrected age.
Main Results:
- ELBW infants demonstrated significantly lower NAA/Cho ratios in the subventricular zone and cortex compared to controls.
- Lower NAA/Cho ratio in the subventricular zone and cortex, and NAA/mIns ratio in the subventricular zone were associated with poorer Bayley mental scores.
Conclusions:
- Abnormalities in brain metabolite ratios detected by MRS at term-equivalent age are linked to impaired cognitive and language development in ELBW infants.
- MRS may serve as an early biomarker for neurodevelopmental deficits in high-risk infant populations.
Background:
Proton magnetic resonance spectroscopy can be used to assess brain integrity and maturation with age.
Objective:
To compare regional cerebral magnetic resonance spectroscopy metabolite ratios in extremely low birth weight and healthy term control infants measured at term-equivalent age and to evaluate association between magnetic resonance spectroscopy metabolites and cognitive and language development at 18-22 months' corrected age.
Methods:
Single-voxel point-resolved spectroscopy sequence was performed in a prospective cohort of 43 infants. Magnetic resonance spectroscopy metabolite ratios of N-acetylaspartate to choline-containing compounds and N-acetylaspartate to myo-inositiol in the hippocampus, cortex, and subventricular zone were associated with Bayley mental, cognitive, and language scores at 18-22 months' corrected age.
Results:
The mean (±S.D.) gestation of the 31 extremely low birth weight population was 25 (±1.1) weeks and mean (±S.D.) birth weight was 749 (±133.9) g. Compared with healthy term control infants, extremely low birth weight infants exhibited consistently lower N-acetylaspartate-to-choline-containing compounds ratios in our three regions of interest, with differences reaching statistical significance for the subventricular zone and cortex regions. In multiple linear regression analyses, N-acetylaspartate-to-choline-containing compounds ratio in the subventricular zone, N-acetylaspartate-to-choline-containing compounds ratio in the cortex, and N-acetylaspartate-to-myo-inositiol ratio in the subventricular zone were significantly associated with Bayley mental scores at 18-22 months' corrected age.
Conclusions:
Magnetic resonance spectroscopy metabolite abnormalities at term-equivalent age appear to be significantly associated with cognitive and language development in extremely low birth weight infants.
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