Metabolic maturation of white matter is altered in preterm infants.
Significant physiological switches occur at birth such as the transition from fetal parallel blood flow to a two-circuit serial system with increased arterial oxygenation of blood delivered to all organs including the brain. In addition, the extra-uterine environment exposes premature infants to a host of stimuli. These events could conceivably alter the trajectory of brain development in premature infants. We used in vivo magnetic resonance spectroscopy to measure absolute brain metabolite concentrations in term and premature-born infants without evidence of brain injury at equivalent post-conceptional age. Prematurity altered the developmental time courses of N-acetyl-aspartate, a marker for axonal and neuronal development, creatine, an energy metabolite, and choline, a membrane metabolite, in parietal white matter. Specifically, at term-equivalency, metabolic maturation in preterm infants preceded development in term infants, but then progressed at a slower pace and trajectories merged at ≈340-370 post-conceptional days. In parieto/occipital grey matter similar trends were noticed but statistical significance was not reached. The timing of white matter development and synchronization of white matter and grey matter maturation in premature-born infants is disturbed. This may contribute to the greater risk of long-term neurological problems of premature infants and to their higher risk for white matter injury.
Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California, United States of America ; Rudi Schulte Research Institute, Santa Barbara, California, United States of America.
Stefan
S
Blüml
Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California, United States of America ; Dornsife Cognitive Neuroscience Imaging Center, USC, Los Angeles, California, United States of America.
Jessica L
JL
Wisnowski
Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California, United States of America.
Marvin D
MD
Nelson
Division of Neonatology, Children's Hospital Los Angeles, Los Angeles, California, United States of America.
Lisa
L
Paquette
Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California, United States of America.
Ashok
A
Panigrahy
D000367:Age Factors; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001834:Body Water / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging / Q000254:growth & development / Q000378:metabolism*; D002794:Choline / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism*; D018698:Glutamic Acid / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D011859:Radiography; D013997:Time Factors; D014867:Water / Q000378:metabolism
D014867:Water; D001224:Aspartic Acid; D018698:Glutamic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline