Brain creatine alteration and executive function deficits in children born very preterm

Abstract

A paper by Schnider and co-workers 1 published recently in Pediatric Research has investigated a possible association between impaired brain metabolism and executive function deficits in 54 children born very preterm (VPT). The authors found lower glutamate-glutamine-to-creatine ratio (Glx/Cr) and higher myoinositol-to-creatine ratio (mI/Cr) in the frontal white matter of VPT children aged 8-15 years, with lower executive functions associated with lower frontal Glx/Cr ratio in both VPT-and termborn peers and higher mI/Cr ratios in the VPT group only. It appears that VPT birth is associated with long-lasting locationspecific metabolic disturbances in the brain of affected children, with such metabolic turmoil partly responsible for deficits reported in executive function at school age. However, these results should be interpreted with caution since the authors failed to account for possible changes in creatine metabolism in VPT while obtaining brain metabolites using proton magnetic resonance spectroscopy (MRS).