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Updated: Sep 10, 2025
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Measures of Brain Metabolism and Diffusion in Neonates of Mothers with Diabetes
Steve C N Hui1,2,3, Nahla M H Elsaid1,2,3, Julius S Ngwa1,3
1From the Developing Brain Institute (S.C.N.H., N.M.H.E., J.S.N., K.K., C.L., N.A.), Children's National Hospital, Washington, DC.
Insights
Infants of diabetic mothers (IDMs) show altered brain metabolites, specifically increased myo-inositol. Diffusion MRI reveals changes in white matter integrity, suggesting potential neurodevelopmental impacts in IDMs.
Area of Science:
- Neonatal neurodevelopment
- Pediatric neuroimaging
- Metabolic disorders
Background:
- Maternal diabetes mellitus (DM) can impact offspring neurodevelopment.
- Early detection of brain abnormalities in infants of diabetic mothers (IDMs) is crucial.
- Brain metabolites and white matter tracts are key indicators of neonatal brain health.
Purpose of the Study:
- To compare brain metabolites and white matter fiber structures in IDMs versus healthy controls.
- To investigate early neurodevelopmental changes in infants exposed to maternal diabetes.
- To identify potential biomarkers for brain abnormality in neonates of diabetic mothers.
Main Methods:
- Prospective recruitment of pregnant women with DM and healthy controls.
- Acquisition of 3T MRI data, including T2-weighted images, 1H-MRS, and diffusion tensor imaging (DTI).
- Comparison of brain metabolites (e.g., myo-inositol, GABA) and diffusion measures (MD, AD) between IDMs and controls using independent sample t-tests and general linear models.
Main Results:
- MRI data obtained from 77 newborns (41 controls, 36 IDMs).
- Significantly higher myo-inositol levels in IDMs compared to controls (p=0.02).
- Increased mean diffusivity (MD) and axial diffusivity (AD) in specific regions of the cingulate gyrus in IDMs, indicating altered white matter integrity.
Conclusions:
- Elevated myo-inositol in IDMs may represent a compensatory response to altered maternal blood glucose levels.
- Increased diffusivity in IDMs suggests potential abnormalities in myelination and axonal development.
- These findings highlight subtle but significant neuroimaging differences in IDMs, warranting further investigation into long-term neurodevelopmental outcomes.
Background And Purpose:
Maternal diabetes may affect neonates' long-term neurodevelopment and cognitive behavior. Brain biochemistry and white matter fiber tracts may reveal early changes of brain abnormality. The purpose of this study was to compare brain metabolites and fiber structures in infants of mothers with diabetes with those of mothers without diabetes during the early stage of neonatal neurodevelopment.
Materials And Methods:
Pregnant women with diabetes mellitus (DM) and healthy controls were recruited prospectively. Baseline characteristics including maternal and gestational age, weight, height, body mass index (BMI), and types of diabetes were extracted from the mothers and neonates in the clinical record. Infants of mothers with diabetes and healthy controls underwent scans by using a 3T MRI scanner. T2-weighted anatomic images were acquired for voxel positioning. 1H-MR spectroscopy from the right frontal lobe and whole-brain DTI data were acquired from the participants. Independent sample t-tests were used to compare anthropometric data and a general linear model was used to compare brain metabolites and diffusion measures in the neonates.
Results:
MRI data were successfully obtained from 77 neonates (41 healthy controls and 36 infants of mothers with diabetes). Gestational diabetes was the most common diagnosis (53%), followed by type 2 (33%) and type 1 pregestational DM (14%). Weight (P = .02) and BMI (P < .01) were significantly higher in mothers with diabetes with earlier birth gestational age. Myo-inositol (mI) measurements were significantly higher (P = .02) in infants of mothers with diabetes versus controls but this was not observed in the excitatory neurotransmitter of γ-aminobutyric acid (GABA) and other high-concentration metabolites. Mean diffusivity values were significantly higher in the anterior part (P = .03) and posterior gray matter (P < .05) of the cingulate gyrus for infants of mothers with diabetes compared with controls. Axial diffusivity values were significantly higher (P = .03) in the anterior part right gray matter of the cingulate gyrus for infants of mothers with diabetes compared with controls.
Conclusions:
The increase of myo-inositol in infants of mothers with diabetes may reflect a compensatory mechanism related to altered blood glucose to preserve and promote β-cell growth to enhance the production of insulin. The increase in mean diffusivity is consistent with decreased water diffusion, which potentially reflects abnormal changes in myelination and axonal loss.
