title: Magnetic resonance spectroscopy at term-equivalent age in extremely preterm infants: association with cognitive and language development.
abstract: BACKGROUND
  Proton magnetic resonance spectroscopy can be used to assess brain integrity and maturation with age.
  
  
  OBJECTIVE
  To compare regional cerebral magnetic resonance spectroscopy metabolite ratios in extremely low birth weight and healthy term control infants measured at term-equivalent age and to evaluate association between magnetic resonance spectroscopy metabolites and cognitive and language development at 18-22 months' corrected age.
  
  
  METHODS
  Single-voxel point-resolved spectroscopy sequence was performed in a prospective cohort of 43 infants. Magnetic resonance spectroscopy metabolite ratios of N-acetylaspartate to choline-containing compounds and N-acetylaspartate to myo-inositiol in the hippocampus, cortex, and subventricular zone were associated with Bayley mental, cognitive, and language scores at 18-22 months' corrected age.
  
  
  RESULTS
  The mean (±S.D.) gestation of the 31 extremely low birth weight population was 25 (±1.1) weeks and mean (±S.D.) birth weight was 749 (±133.9) g. Compared with healthy term control infants, extremely low birth weight infants exhibited consistently lower N-acetylaspartate-to-choline-containing compounds ratios in our three regions of interest, with differences reaching statistical significance for the subventricular zone and cortex regions. In multiple linear regression analyses, N-acetylaspartate-to-choline-containing compounds ratio in the subventricular zone, N-acetylaspartate-to-choline-containing compounds ratio in the cortex, and N-acetylaspartate-to-myo-inositiol ratio in the subventricular zone were significantly associated with Bayley mental scores at 18-22 months' corrected age.
  
  
  CONCLUSIONS
  Magnetic resonance spectroscopy metabolite abnormalities at term-equivalent age appear to be significantly associated with cognitive and language development in extremely low birth weight infants.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital and The Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio. Electronic address: Nehal.Parikh@nationwidechildrens.org.
authors.forename: Roopali
authors.initials: R
authors.lastname: Bapat
authors.affiliation: Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center, Houston, Texas.
authors.forename: Ponnada A
authors.initials: PA
authors.lastname: Narayana
authors.affiliation: Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center, Houston, Texas.
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Division of Neonatology, Department of Pediatrics, Nationwide Children's Hospital and The Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio; Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital and The Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Nehal A
authors.initials: NA
authors.lastname: Parikh
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D002657:Child Development / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D003401:Creatine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature / Q000502:physiology*; D007804:Language Development; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D012189:Retrospective Studies
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine
keywords: extremely low birth weight (ELBW) infants; extremely preterm infants; neurodevelopmental outcome; proton magnetic resonance spectroscopy (MRS)