title: Perinatal complications and abnormal proton metabolite concentrations in frontal cortex of adolescents seen on magnetic resonance spectroscopy.
abstract: OBJECTIVE
  The relation of perinatal complications to metabolism of orbitofrontal cortex was studied in 12 normal adolescents aged 13 to 17 years.
  
  
  BACKGROUND
  Perinatal complications are associated with both (a) behavioral signs of frontal lobe dysfunction and (b) increased risk for mood disorders and schizophrenia. Perinatal complications are not usually sufficient to produce these disorders, however, suggesting an etiologic model in which perinatal complications interact with a second, familial, liability factor. The present study tested a key prediction of this "two-factor" model, namely, that perinatal complications will be associated with physiologic signs of frontal dysfunction, even in persons who have no personal or family history of these psychiatric disorders.
  
  
  METHODS
  Subjects were screened by structured interviews with the Kiddie Schedule for Affective Disorders and Schizophrenia and had no personal or family history of psychiatric disorder. Ratios of choline and N-acetyl aspartate to creatine in orbitofrontal cortex were measured using proton magnetic resonance spectroscopy. Perinatal complications were scored with the examiners blinded to magnetic resonance spectroscopy data, applying published scales to hospital records on subjects' gestations and births.
  
  
  RESULTS
  Perinatal complications were significantly correlated with reduced concentrations of choline and N-acetyl aspartate.
  
  
  CONCLUSIONS
  Our results complement earlier findings of significant relations between perinatal complications and signs of frontal lobe dysfunction, as well as elevated rates of these two types of variables in mood disorders and schizophrenia.
authors.affiliation: Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Kinney
authors.forename: R J
authors.initials: RJ
authors.lastname: Steingard
authors.forename: P F
authors.initials: PF
authors.lastname: Renshaw
authors.forename: D A
authors.initials: DA
authors.lastname: Yurgelun-Todd
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D002794:Choline / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000002:abnormalities* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D009682:Magnetic Resonance Spectroscopy; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000503:physiopathology; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000503:physiopathology; D011297:Prenatal Exposure Delayed Effects
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline