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Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes
  1. Reina Hyodo1,
  2. Yoshiaki Sato1,
  3. Miharu Ito1,
  4. Yuichiro Sugiyama1,
  5. Chikako Ogawa2,
  6. Hisashi Kawai3,
  7. Toshiki Nakane3,
  8. Akiko Saito1,
  9. Akihiro Hirakawa4,
  10. Hiroyuki Kidokoro2,5,
  11. Jun Natsume2,5,
  12. Masahiro Hayakawa1
  1. 1Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
  2. 2Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
  3. 3Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  4. 4Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  5. 5Brain and Mind Research Center, Nagoya University, Nagoya, Japan
  1. Correspondence to Dr Yoshiaki Sato, Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, 65 Tsurumai-cho Showa-ku, Nagoya 466-8560, Japan; yoshiaki{at}med.nagoya-u.ac.jp

Abstract

Objective To compare magnetic resonance spectroscopy (MRS) metabolite ratios in preterm infants at term-equivalent age with those in term infants and to evaluate the association between MRS metabolites and neurodevelopmental outcomes at 18 months corrected age in preterm infants.

Design We studied infants born at a gestational age <37 weeks and weighing <1500 g during 2009–2013 using MRS at term-equivalent age. Infants with major brain abnormalities were excluded. The ratios of N-acetylaspartate (NAA) to creatine (Cre), NAA to choline-containing compounds (Cho) and Cho to Cre in the frontal white matter and thalamus were measured using multivoxel point-resolved proton spectroscopy sequence. Neurodevelopmental outcomes were assessed at 18 months corrected age.

Results Thirty-three preterm infants and 16 term infants were enrolled in this study. Preterm infants with normal development at 18 months showed significantly lower NAA/Cho ratios in the frontal white matter than term infants. There were no differences in the Cre/Cho ratios between preterm and term infants. At 18 months corrected age, 9 preterm infants with a mild developmental delay showed significantly lower NAA/Cho ratios in the thalamus than 24 preterm infants with normal development.

Conclusions Preterm infants at term-equivalent age showed reduced MRS metabolites (NAA/Cho) compared with term infants. Decreased NAA/Cho ratios in the thalamus were associated with neurodevelopmental delay at 18 months corrected age in preterm infants.

  • Preterm Infants
  • N-acetylaspartate
  • Biomarker
  • Magnetic Resonance Spectroscopy
  • Neurodevelopment

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Footnotes

  • Contributors RH, YS, HKi and MH were in charge of the conception and design of the work. MI, YS and AS took major responsibility for infants' treatment, their guardians' consents for MRI and magnetic resonance spectroscopic (MRS) and were involved in data collection. TN and HKa analysed MRI and MRS images. RH, AS, MI, YS, CO, HKi, JN and MH evaluated MRI images. AHi supervised statistical analyses. RH was actively involved in data collection and analysed the data. RH, YS, MH and HKi wrote the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Local Ethics Committee of Nagoya University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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