Temporal brain metabolite changes in preterm infants with normal development

Brain Dev. 2017 Mar;39(3):196-202. doi: 10.1016/j.braindev.2016.10.006. Epub 2016 Nov 9.


Objective: Preterm infants are at high risk for developmental delay, epilepsy, and autism spectrum disorders. Some reports have described associations between these conditions and gamma-aminobutyric acid (GABA) dysfunction; however, no study has evaluated temporal changes in GABA in preterm infants. Therefore, we assessed temporal changes in brain metabolites including GABA using single-voxel 3-Tesla (T) proton magnetic resonance spectroscopy (1H-MRS) in preterm infants with normal development.

Methods: We performed 3T 1H-MRS at 37-46 postmenstrual weeks (PMWs, period A) and 64-73PMWs (period B). GABA was assessed with the MEGA-PRESS method. N-acetyl aspartate (NAA), glutamate-glutamine complex (Glx), creatine (Cr), choline (Cho), and myo-inositol (Ins) were assessed with the PRESS method. Metabolite concentrations were automatically calculated using LCModel.

Results: Data were collected from 20 preterm infants for periods A and B (medians [ranges], 30 [24-34] gestational weeks, 1281 [486-2030]g birth weight). GABA/Cr ratio decreased significantly in period B (p=0.03), but there was no significant difference in GABA/Cho ratios (p=0.58) between the two periods. In period B, NAA/Cr, Glx/Cr, NAA/Cho, and Glx/Cho ratios were significantly increased (p<0.01), whereas Cho/Cr, Ins/Cr, and Ins/Cho ratios were significantly decreased (p<0.01). There was no significant difference for GABA or Cho concentrations (p=0.52, p=0.22, respectively). NAA, Glx, and Cr concentrations were significantly increased (p<0.01), whereas Ins was significantly decreased (p<0.01).

Conclusions: Our results provide new information on normative values of brain metabolites in preterm infants.

Keywords: Brain metabolites; Magnetic resonance spectroscopy; Preterm infants.

MeSH terms

  • Birth Weight / physiology*
  • Brain / growth & development*
  • Brain / metabolism*
  • Brain / pathology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature / metabolism*
  • Magnetic Resonance Spectroscopy
  • Male
  • Pregnancy
  • Premature Birth / metabolism*