Abstract
Neurometabolic sequelae of children born at very LBW (VLBW) are not well characterized in early childhood. Proton magnetic resonance spectroscopy (1H-MRS) and developmental assessments were acquired from children age 18–22 mo (16 VLBW/7 term) and 3–4 y (12 VLBW/8 term) from the anterior cingulate and left frontal periventricular white matter. Metabolites obtained included combined N-acetylaspartylglutamate and N-acetylaspartate (NAA), total choline-containing compounds (Cho), combined glutamate and glutamine (Glx), combined creatine and phosphocreatine (Cr), myoinositol (mI), and the following ratios: NAA/Cr, Cho/Cr, Glx/Cr, mI/Cr, and NAA/Cho. Significant differences were present only in white matter: at 18–22 mo, NAA was decreased in VLBW children (p < 0.04), and at 3–4 y, VLBW children showed lower Cr (p < 0.01), lower NAA/Cho (p < 0.005), higher Glx/Cr (p < 0.02), and higher Cho/Cr (p < 0.005). On developmental testing, VLBW children scored lower on language expression (p < 0.05) and on the A-not-B test of early executive function (p < 0.01) at 18–22 mo and had lower verbal intelligence quotient (IQ) (p < 0.005), performance IQ (p < 0.04), and several measures of early executive function including the bear-dragon test (p < 0.004), gift delay (p < 0.07), and summary categorization score (p < 0.03) at 3–4 y. VLBW children may have neurometabolic and developmental abnormalities that persist at least through early childhood.
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Abbreviations
- 1H-MRS:
-
proton magnetic resonance spectroscopy
- BSID-III:
-
Bayley Scales of Infant Development-III
- Cho:
-
total choline-containing compounds
- Cr:
-
combined creatine and phosphocreatine
- Glx:
-
combined glutamate and glutamine
- mI:
-
myoinositol
- NAA:
-
combined N-acetylaspartylglutamate and N-acetylaspartate
- PIQ:
-
performance intelligence quotient
- TE:
-
echo time
- IQ:
-
intelligence quotient
- VIQ:
-
verbal intelligence quotient
- VLBW:
-
very LBW
- WPPSI-III:
-
Wechsler Preschool and Primary Scale of Intelligence-III
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Acknowledgements
We gratefully acknowledge the critical role played by the following people: Susanne Duvall, Lynette Silva, Diana South, Cathy Smith, Judith Segall, Joy Van Meter, Becky Montman, Carol Hartenberger, Mashid Rhoohi, Conra Backstrom-Lacy, and Dr. Joyce Phillips.
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Supported by grants from University of New Mexico Clinical and Translational Science Center 1ULRR031977-01, and The Mind Research Network (Department of Energy grant #DE-FG02-08ER64581) [to J.P.P.].
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Phillips, J., Ruhl, D., Montague, E. et al. Anterior Cingulate and Frontal Lobe White Matter Spectroscopy in Early Childhood of Former Very LBW Premature Infants. Pediatr Res 69, 224–229 (2011). https://doi.org/10.1203/PDR.0b013e3182091d52
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DOI: https://doi.org/10.1203/PDR.0b013e3182091d52
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