Can magnetic resonance spectroscopy predict neurodevelopmental outcome in very low birth weight preterm infants?

Augustine, Erin; Spielman, Daniel M.; Barnes, Patrick D.; Sutcliffe, Trenna L.; Dermon, J. D.; Mirmiran, M.; Clayton, David; Ariagno, Ron

doi:10.1038/jp.2008.66

Cited by 35 publications

(28 citation statements)

References 31 publications

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“…A decreased NAA/Cho ratio in the thalamus and white matter may indicate neurodevelopmental delay at 18 months corrected age. In contrast, Augustine et al reported that NAA/Cho, NAA/Cre and Cho/Cre ratios in the thalamus and basal ganglia were not predictive of Bayley scores at 18–24 months adjusted age 37. However, they used a larger voxel size than that in our study, which may have affected tissue specificity and resulted in regions of interest, including non-targeted tissues.…”

Section: Discussioncontrasting

confidence: 65%

Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes

Hyodo

Sato

Ito

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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Section: Discussioncontrasting

confidence: 65%

Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes

Hyodo

Sato

Ito

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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“…Three reported studies have examined the relationship of MRS cerebral metabolites and neurodevelopment in preterm infants. Augustine et al 32 did not identify any correlations between metabolite ratios in 36 very low birth weight preterm infants at the level of the basal ganglia and supraventricular level and Bayley mental and psychomotor scores at 18-24 months’ corrected age. Use of categorical rather than continuous outcomes and the small number of infants (n = 8) with abnormal neurodevelopmental outcomes likely resulted in reduced study power to find meaningful correlations.…”

Section: Discussionmentioning

confidence: 93%

Magnetic Resonance Spectroscopy at Term-Equivalent Age in Extremely Preterm Infants: Association With Cognitive and Language Development

Bapat

Narayana

Zhou

et al. 2014

Pediatric Neurology

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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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“…At the same time, recent studies have documented associations between NAA/choline ratios in preterm neonates and later developmental outcome[65–67] (but see also [68]). Although without outcome data, we cannot speculate on the clinical significance of the associations between white matter metabolism and thalamic volume observed in our study, these findings suggest that the observed association between NAA/choline and outcome might be further mediated by changes to the developing corticothalamic system.…”

Section: Discussionmentioning

confidence: 99%

Reduced thalamic volume in preterm infants is associated with abnormal white matter metabolism independent of injury

et al. 2015

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Introduction Altered thalamocortical development is hypothesized to be a key substrate underlying neurodevelopmental disabilities in preterm infants. However, the pathogenesis of this abnormality is not well-understood. We combined magnetic resonance spectroscopy of the parietal white matter and morphometric analyses of the thalamus to investigate the association between white matter metabolism and thalamic volume and tested the hypothesis that thalamic volume would be associated with diminished N-acetyl-aspartate (NAA), a measure of neuronal/axonal maturation, independent of white matter injury. Methods Data from 106 preterm infants (mean gestational age at birth: 31.0 weeks ± 4.3; range 23–36 weeks) who underwent MR examinations under clinical indications were included in this study. Results Linear regression analyses demonstrated a significant association between parietal white matter NAA concentration and thalamic volume. This effect was above and beyond the effect of white matter injury and age at MRI and remained significant even when preterm infants with punctate white matter lesions (pWMLs) were excluded from the analysis. Furthermore, choline, and amongst the preterm infants without pWMLs, lactate concentrations were also associated with thalamic volume. Of note, the associations between NAA and choline concentration and thalamic volume remained significant even when the sample was restricted to neonates who were term-equivalent age or older. Conclusion These observations provide convergent evidence of a neuroimaging phenotype characterized by widespread abnormal thalamocortical development and suggest that the pathogenesis may involve impaired axonal maturation.

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Can magnetic resonance spectroscopy predict neurodevelopmental outcome in very low birth weight preterm infants?

Cited by 35 publications

References 31 publications

Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes

Magnetic resonance spectroscopy in preterm infants: association with neurodevelopmental outcomes

Magnetic Resonance Spectroscopy at Term-Equivalent Age in Extremely Preterm Infants: Association With Cognitive and Language Development

Reduced thalamic volume in preterm infants is associated with abnormal white matter metabolism independent of injury

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