Altered posterior cingulate brain metabolites and cognitive dysfunction in preterm adolescents
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Published on: August 18, 2020
Jeanie L Y Cheong1,2,3, Alan Bainbridge4, Peter J Anderson2,5,6
1Neonatal Services, Royal Women's Hospital, Melbourne, Australia.
Insights
Extremely preterm birth is linked to altered brain metabolite ratios, potentially explaining long-term cognitive deficits in survivors. These changes in neuronal and cell membrane markers may impact intelligence, memory, and attention.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Extremely preterm (EP) individuals (<28 weeks gestation) face higher risks of cognitive deficits.
- The posterior cingulate's role in cognition is established, but its alteration by preterm birth remains unclear.
- Investigating brain metabolite differences in EP individuals is crucial for understanding cognitive outcomes.
Purpose of the Study:
- To compare brain metabolite ratios (neuronal and cell membrane markers) in 18-year-old extremely preterm individuals versus controls.
- To explore the association between these metabolite ratios and cognitive functions (IQ, memory, attention).
Main Methods:
- Proton magnetic resonance spectroscopy (MRS) measured cerebral metabolites in the posterior cingulate of 150 EP individuals and 134 controls.
- Key ratios analyzed were total N-acetylaspartate (tNAA)/total creatine (tCr) and total choline (tCho)/tCr.
- Linear and logistic regressions assessed group differences and correlations with cognitive test scores.
Main Results:
- EP individuals exhibited significantly lower tNAA/tCr and tCho/tCr ratios compared to controls (P=0.02).
- Higher tCho/tCr correlated with better IQ specifically in the EP group.
- Elevated tNAA/tCr ratios were associated with improved working memory and attention in both EP and control groups.
Conclusions:
- Extremely preterm birth is associated with lasting alterations in posterior cingulate brain metabolite ratios.
- These neurochemical changes may contribute to the observed long-term cognitive impairments in extremely preterm survivors.
Background:
Extremely preterm (EP, <28 wk gestation) individuals have increased the risk of cognitive deficits compared with controls. The posterior cingulate region has an important role in cognitive function, but how this is affected by preterm birth is unknown. We aimed to compare brain metabolite ratios of neurons and cell membranes between EP 18-y olds and controls, and explore the association between metabolite ratios and cognitive outcomes.
Method:
A regional cohort of 150 EP and 134 controls were recruited for the study. Cerebral metabolites were measured using proton magnetic resonance spectroscopy (MRS) obtained from a left posterior cingulate voxel. Total N-acetylaspartate (tNAA, neuronal marker)/total creatine (tCr), and total choline (tCho, cell membrane marker)/tCr ratios were compared between groups using linear regression. Metabolite ratios were correlated with tests of general intelligence (IQ), memory, and attention using linear or logistic regression.
Results:
Compared with controls, EP had lower tNAA/tCr (mean difference (95% CI) of -2.27% (-4.09, -0.45)) and tCho/tCr (mean difference (95% CI) of -11.11% (-20.37, -1.85)), all P = 0.02. Higher tCho/tCr correlated with better IQ in the EP group only; whereas higher tNAA/tCr ratios correlated with better scores in working memory and attention in both groups.
Conclusion:
EP birth is associated with long-term brain metabolite ratio alterations. This may underlie poorer cognitive performance in EP survivors.
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