Abstract
Background: Diffuse white matter (WM) injury is the commonest MR finding in preterm infants. We aimed to describe the metabolic signature of diffuse WM injury and correlate to neurodevelopmental outcome at 1 year.
Methods: 45 preterm infants (< 32 weeks) underwent single WM voxel point-resolved spectroscopy (fig1A&B) at mean corrected gestational age (CGA) of 40±1.6 weeks. Metabolite ratios were quantified using AMARES algorithm. Bayley III was performed at a corrected age of 1 year. Infants with scores < -1SD in each domain classified as impaired.
(A) The MRS voxel postitioned in left PWM on an axial image. (B) Representative 1H spectra from babies with and without motor impairment. (C) Metabolite ratios in babies with and without motor impaiment at 1 year corrected PN age.
Results: Only Naa/Cho correlated to gestation at birth (r=0.39 p< 0.05). 1 year outcome data was available for 42/45. Mean cognitive (96±14) and motor (87±15) composite scores were within the normative population range. Motor outcomes significantly correlated with both Naa/Cho and Cho/Cr ratios before and after correction for gestational age (table 1). After excluding babies with brain abnormalities, there was a significant increase in Cho/Cr in the motor impaired group (p< 0.05) (fig1C).
Conclusions: Localised white matter proton MRS Cho/Cr at term corrected age may provide a useful biomarker of motor outcome in preterm infants.
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Kendall, G., Price, D., Bainbridge, A. et al. Impaired Neurodevelopmental Outcome Associated with Increased White Matter CHO/CR in Preterm Infants. Pediatr Res 70 (Suppl 5), 180 (2011). https://doi.org/10.1038/pr.2011.405
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DOI: https://doi.org/10.1038/pr.2011.405
