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Updated: Nov 6, 2025
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Brain proton magnetic resonance spectroscopy and neurodevelopment after preterm birth: a systematic review
Burcu Cebeci1,2, Thomas Alderliesten1, Jannie P Wijnen3
1Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands.
Insights
Proton magnetic resonance spectroscopy (1H-MRS) in preterm infants can predict neurodevelopmental outcomes. Metabolite ratios, particularly N-acetylaspartate/choline (NAA/Cho) in white matter, show strong associations with motor, cognitive, and language development.
Area of Science:
- Neuroscience
- Medical Imaging
- Developmental Pediatrics
Background:
- Preterm infants face significant risks of neurodevelopmental impairments.
- Proton magnetic resonance spectroscopy (1H-MRS) is a tool for assessing brain metabolites, currently used in term infants with asphyxia.
- The utility of 1H-MRS for predicting neurodevelopmental outcomes in preterm infants requires further investigation.
Conclusions:
- 1H-MRS at term-equivalent age is associated with later motor, cognitive, and language outcomes in preterm infants.
- NAA/Cho ratios in white matter and deep gray matter show specific correlations with different developmental domains.
- 1H-MRS at term-equivalent age shows promise as an early indicator of brain development and neurodevelopmental prognosis in preterm infants, with NAA findings being particularly predictive.
Background:
Preterm infants are at risk of neurodevelopmental impairments. At present, proton magnetic resonance spectroscopy (1H-MRS) is used to evaluate brain metabolites in asphyxiated term infants. The aim of this review is to assess associations between cerebral 1H-MRS and neurodevelopment after preterm birth.
Methods:
PubMed and Embase were searched to identify studies using 1H-MRS and preterm birth. Eligible studies for this review included 1H-MRS of the brain, gestational age ≤32 weeks, and neurodevelopment assessed at a corrected age (CA) of at least 12 months up to the age of 18 years.
Results:
Twenty papers evaluated 1H-MRS in preterm infants at an age between near-term and 18 years and neurodevelopment. 1H-MRS was performed in both white (WM) and gray matter (GM) in 12 of 20 studies. The main regions were frontal and parietal lobe for WM and basal ganglia for GM. N-acetylaspartate/choline (NAA/Cho) measured in WM and/or GM is the most common metabolite ratio associated with motor, language, and cognitive outcome at 18-24 months CA.
Conclusions:
NAA/Cho in WM assessed at term-equivalent age was associated with motor, cognitive, and language outcome, and NAA/Cho in deep GM was associated with language outcome at 18-24 months CA.
Impact:
In preterm born infants, brain metabolism assessed using 1H-MRS at term-equivalent age is associated with motor, cognitive, and language outcomes at 18-24 months. 1H-MRS at term-equivalent age in preterm born infants may be used as an early indication of brain development. Specific findings relating to NAA were most predictive of outcome.
