title: Diffusion-weighted imaging and magnetic resonance proton spectroscopy following preterm birth.
abstract: OBJECTIVE
  To study the associations between magnetic resonance proton spectroscopy (MRS) data and apparent diffusion coefficients (ADC) from the preterm brain with developmental outcome at 18 months corrected age and clinical variables.
  
  
  METHODS
  A prospective observational cohort study of 67 infants born before 35 weeks gestational age who received both magnetic resonance imaging of the brain between 37 and 44 weeks corrected gestational age and developmental assessment around 18 months corrected age.
  
  
  RESULTS
  No relationships were found between ADC values and MRS results or outcome. MRS ratios involving N-acetyl aspartate (NAA) from the posterior white matter were associated with "severe" and "moderate to severe" difficulties, and fine motor scores were significantly lower in participants with a visible lactate doublet in the posterior white matter. The presence of a patent ductus arteriosus (PDA) was the only clinical factor related to NAA ratios.
  
  
  CONCLUSIONS
  Altered NAA levels in the posterior white matter may reflect subtle white matter injury associated with neuro-developmental difficulties, which may be related to a PDA. Further work is needed to assess the longer-term neuro-developmental implications of these findings, and to study the effect of PDAs on developmental outcome in later childhood/adolescence.
authors.affiliation: Department of Paediatric Neurology and Child Development, Ryegate Children's Centre, Sheffield Children's Hospital NHS Foundation Trust, Tapton Crescent Road, Sheffield S10 5DD, UK. Electronic address: anthony.hart@sch.nhs.uk.
authors.forename: A R
authors.initials: AR
authors.lastname: Hart
authors.affiliation: Department of Neonatology, Jessop Wing, Sheffield Teaching Hospitals NHS, Foundation Trust, Tree Root Walk, Sheffield S10 2SF, UK.
authors.forename: M F
authors.initials: MF
authors.lastname: Smith
authors.affiliation: Academic Unit of Radiology, University of Sheffield, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: E H
authors.initials: EH
authors.lastname: Whitby
authors.affiliation: Department of Paediatric Neurology and Child Development, Ryegate Children's Centre, Sheffield Children's Hospital NHS Foundation Trust, Tapton Crescent Road, Sheffield S10 5DD, UK.
authors.forename: S
authors.initials: S
authors.lastname: Alladi
authors.affiliation: Department of Neonatology, Jessop Wing, Sheffield Teaching Hospitals NHS, Foundation Trust, Tree Root Walk, Sheffield S10 2SF, UK.
authors.forename: S
authors.initials: S
authors.lastname: Wilkinson
authors.affiliation: Academic Unit of Radiology, University of Sheffield, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: M N
authors.initials: MN
authors.lastname: Paley
authors.affiliation: Academic Unit of Radiology, University of Sheffield, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: P D
authors.initials: PD
authors.lastname: Griffiths
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001921:Brain / Q000473:pathology*; D001923:Brain Chemistry; D001931:Brain Mapping / Q000379:methods*; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004374:Ductus Arteriosus, Patent / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D009186:Myelin Sheath / Q000737:chemistry; D009413:Nerve Fibers, Myelinated / Q000737:chemistry / Q000473:pathology; D011247:Pregnancy; D047928:Premature Birth / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate