Temporal brain metabolite changes in preterm infants with normal development

Tanifuji, Sachiko; Akasaka, Manami; Kamei, Atsushi; Araya, Nami; Asami, Maya; Matsumoto, Atsushi; Sotodate, Genichiro; Konishi, Yu; Shirasawa, Satoko; Toya, Yukiko; Kusano, Syuji; Chida, Shoichi; Sasaki, Makoto; Matsuda, Tsuyoshi

doi:10.1016/j.braindev.2016.10.006

Cited by 19 publications

(25 citation statements)

References 21 publications

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“…All metabolite concentrations are reported in institutional units (i.u.). Given the low GABA, glutamate and Glx levels in the preterm brain, we accepted Cramer-Rao lower bound (CRLB) confidence intervals up to 40% for these metabolites to obtain a more representative data sample 13,19,26 . All other metabolite concentrations were included for analysis only if their CRLB were lower than 20%.…”

Section: Mri and 1 H-mrs Acquisitionmentioning

confidence: 99%

“…However, in vivo assessment of GABA in the developing human preterm brain has been limited by motion artifacts on non-sedated neonatal scans, the small brain volumes limiting the size of the 1 H-MRS voxel, the limited availability of high magnetic field strength MRI scanners for this population and additional challenges associated with intensive care support during early postnatal life. Recent reports using the MEGA-PRESS technique have shown lower GABA and glutamate concentrations at term-equivalent age (TEA, between 37 to 41 weeks postmenstrual age) and a negative correlation with functional connectivity in small cohorts of preterm infants (born <35 weeks gestational age) compared to healthy full-term infants [17][18][19] .…”

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confidence: 99%

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Age and Sex Influences Gamma-aminobutyric Acid Concentrations in the Developing Brain of Very Premature Infants

Basu

Pradhan

Jacobs

et al. 2020

Sci Rep

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Gamma-aminobutyric acid (GABA) and glutamate are principal neurotransmitters essential for late gestational brain development and may play an important role in prematurity-related brain injury. In vivo investigation of GABA in the preterm infant with standard proton magnetic resonance spectroscopy (1 H-MRS) has been limited due to its low concentrations in the developing brain, and overlap in the spectrum by other dominant metabolites. We describe early postnatal profiles of in vivo GABA and glutamate concentrations in the developing preterm brain measured by using the J-difference editing technique, Mescher-Garwood point resolved spectroscopy. We prospectively enrolled very preterm infants born ≤32 weeks gestational age and non-sedated 1 H-MRS (echo time 68 ms, relaxation time 2000 ms, 256 signal averages) was acquired on a 3 Tesla magnetic resonance imaging scanner from a right frontal lobe voxel. Concentrations of GABA + (with macromolecules) was measured from the J-difference spectra; whereas glutamate and composite glutamate + glutamine (Glx) were measured from the unedited (OFF) spectra and reported in institutional units. We acquired 42 reliable spectra from 38 preterm infants without structural brain injury [median gestational age at birth of 28.0 (IQR 26.0, 28.9) weeks; 19 males (50%)] at a median postmenstrual age of 38.4 (range 33.4 to 46.4) weeks. With advancing post-menstrual age, the concentrations of glutamate OFF increased significantly, adjusted for co-variates (generalized estimating equation β = 0.22, p = 0.02). Advancing postnatal weeks of life at the time of imaging positively correlated with GABA + (β = 0.06, p = 0.02), glutamate OFF (β = 0.11, p = 0.02) and Glx OFF (β = 0.12, p = 0.04). Male infants had higher GABA + (1.66 ± 0.07 vs. 1.33 ± 0.11, p = 0.01) concentrations compared with female infants. For the first time, we report the early ex-utero developmental profile of in vivo GABA and glutamate stratified by age and sex in the developing brain of very preterm infants. This data may provide novel insights into the pathophysiology of neurodevelopmental disabilities reported in preterm infants even in the absence of structural brain injury. Advances in perinatal intensive care have improved survival and decreased severe sensory-motor impairments and neuro-developmental disabilities in very preterm infants [born before 32 weeks gestational age (GA)] 1-3. Despite these important advances, 1 in 3 surviving very preterm infants continue to suffer from debilitating cognitive and social-behavioral impairments even in the absence of destructive brain lesions such as high-grade intraventricular hemorrhage or periventricular leukomalacia 4,5. The importance of early detection of subtle brain injury is emphasized by the increasing population of surviving preterm infants with special needs 2,5. These data suggests that less fulminant microstructural brain injury or disturbed maturation, undetected by head ultrasound

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Section: Mri and 1 H-mrs Acquisitionmentioning

confidence: 99%

mentioning

confidence: 99%

Age and Sex Influences Gamma-aminobutyric Acid Concentrations in the Developing Brain of Very Premature Infants

Basu

Pradhan

Jacobs

et al. 2020

Sci Rep

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show abstract

“…As development proceeds, the metabolite variability also reflects different GA at scan as well as different disease processes. 5,[22][23][24][25][26] We believe the heterogeneity of measured ratios adds to, rather than detracts from, the generalizability of our comparison data.…”

Section: Discussionmentioning

confidence: 86%

“…In addition, ratios differed in WM and BG in both groups, perhaps reflecting different susceptibilities to injury, different rates of maturation with development, as well as overall differences in metabolism. As development proceeds, the metabolite variability also reflects different GA at scan as well as different disease processes . We believe the heterogeneity of measured ratios adds to, rather than detracts from, the generalizability of our comparison data.…”

Section: Discussionmentioning

confidence: 99%

Identifying the translational complexity of magnetic resonance spectroscopy in neonates and infants

et al. 2019

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Little attention has been paid to relating MRS outputs of vendor‐supplied platforms to those from research software. This comparison is crucial to advance MRS as a clinical prognostic tool for disease or injury, recovery, and outcome. The work presented here investigates the agreement between metabolic ratios reported from vendor‐provided and LCModel fitting algorithms using MRS data obtained on Siemens 3 T TIM Trio and 3 T Skyra MRI scanners in a total of 55 premature infants and term neonates with hypoxic ischemic encephalopathy (HIE). We compared peak area ratios in single voxels placed in basal ganglia (BG) and frontal white matter (WM) using standard PRESS (TE = 30 ms and 270 ms) and STEAM (TE = 20 ms) MRS sequences at multiple times after birth from 5 to 60 days. A total of 74 scans met quality standards for inclusion, reflecting a spectrum of neonatal disease and several months of early infant development. For the long TE PRESS sequence, N‐acetylaspartate (NAA) and Choline (Cho) ratios to Creatine (Cr) correlated strongly between LCModel and vendor‐supplied software in the BG. For shorter TEs, the ratios of NAA/Cr and Cho/Cr were more closely related using STEAM at TE = 20 ms in BG and WM, which was significantly better than using PRESS at TE = 30 ms in the BG of HIE infants. At short TEs, however, it is still unclear which MRS sequence, STEAM or PRESS, is superior and thus more work is required in this regard for translating research‐generated MRS ratios to clinical diagnosis and prognostication, and unlocking the potential of MRS for in vivo metabolomics. MRS at both long and short TEs is desirable for standard metabolites such as NAA, Cho and Cr, along with important lower concentration metabolites such as myo‐inositol and glutathione.

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“…In twin children, complications occurring during childbirth and early childhood are considered as risk factors for child development 13 . Thus, they may later develop cognitive, linguistic or behavioral changes and cannot completely exclude later adverse neurological outcomes 14,15 . Language acquisition depends on neurobiological and social factors, which include the integrity of brain structures, proper cognitive function, social interaction, and the stimuli received in the child's environment.…”

Section: Introductionmentioning

confidence: 99%

Description of the linguistic and neurological findings of twins born preterm at twoyears of age

Souza

Casais-e-Silva

Sena

2019

jhgd

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Introduction: Prematurity, low birth weight and multiple births are risk factors for structural changes in the brain, as well as deviations in motor, cognitive, social and language development. Objective: To describe language findings and investigate the presence of neurological changes in preterm twins born at two years of age. Method: This is a cross-sectional study based on data analysis of the medical records of six pairs of low birth weight preterm twins, of both sexes, at two years of age, attended to at the State Center for the Prevention and Rehabilitation of Persons withDisabilities - CEPRED, in Salvador-Bahia-Brazil. To this end, information regarding birth was collected; the clinical history; the imaging exams; and the speech, neurological and interdisciplinary assessments. Results: preterm twins had atypical language development and neurological changes that may compromise oral language development. From the neurological point of view, abnormalities common to the premature newborn, such as peri-intraventricular hemorrhage, were observed. Conclusion: Multiple births associated with prematurity and low birth weight may pose risks to the childs language acquisition.

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Temporal brain metabolite changes in preterm infants with normal development

Cited by 19 publications

References 21 publications

Age and Sex Influences Gamma-aminobutyric Acid Concentrations in the Developing Brain of Very Premature Infants

Age and Sex Influences Gamma-aminobutyric Acid Concentrations in the Developing Brain of Very Premature Infants

Identifying the translational complexity of magnetic resonance spectroscopy in neonates and infants

Description of the linguistic and neurological findings of twins born preterm at twoyears of age

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