Background Proton magnetic resonance spectroscopy (MRS) is a noninvasive technique that quantitatively measures specific metabolites in the brain. Normal changes in metabolite ratios near term age in VLBW preterm infants may have diagnostic and prognostic value if they fail to attain term infant levels.
Objective Obtain preliminary data on normal changes in metabolite ratios between 35 and 43 wks postmenstrual age (PMA) in very low birth weight preterm infants.
Methods Thirty-six infants, BWt ≤ 1,510 g, GA ≤ 32 wk, had scan between 35 and 43 wk PMA. Bayley Scales of Infant Development II were done at 18-24 mo corrected age. MRS was performed on a 1.5 Tesla GE Healthcare scanner. Metabolite spectra analyzed were (1) combined left and right thalamus and basal ganglia and (2) left and right cortex. Choline and choline-containing compounds (Ch), creatine and phosphocreatine (Cr), and N-acetylaspartate (NAA) peaks were integrated and the ratios of Ch/Cr, NAA/Cr, and NAA/Ch were calculated. This study was approved by the Panel on Human Subjects in Medical Research at Stanford.
Results Twenty-four and 26 infants had a normal MDI (≥ 85) and normal PDI (≥ 85), respectively. Metabolite ratios could be calculated for 12 and 14 infants in the thalamus and basal ganglia and 22 and 24 infants in the cortex, MDI and PDI respectively. A positive correlation was only found between PMA and NAA/Ch in the thalamus and basal ganglia for infants with a normal *MDI (r 2= .35, p = .04;*see Figure) and a normal PDI (r 2= .36, p = .02).
Conclusion The ratio of NAA/Ch in the thalamus and basal ganglia was greater at 43 wk PMA, possibly reflecting neuronal and myelination development.
Acknowledgment EMV was a summer medical student research awardee from the American Pediatric Society and Society for Pediatric Research.
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