title: Assessing Temporal Brain Metabolite Changes in Preterm Infants Using Multivoxel Magnetic Resonance Spectroscopy.
abstract: OBJECTIVE
  To investigate temporal changes in brain metabolites during the first year of life in preterm infants using multivoxel proton magnetic resonance spectroscopy ((1)H-MRS).
  
  
  METHODS
  Seventeen infants born at 29 (25-33) gestational week (median, range) weighing 1104 (628-1836) g underwent 1.5-T multivoxel (1)H-MRS at 42 postconceptional week (PCW) and at 3, 6, 9, and 12 months after. We measured N-acetyl aspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (Ins)/Cr, NAA/Cho, and Ins/Cho ratios in the frontal lobe (FL) and basal ganglia and thalamus (BG + Th). Linear regression analyses were performed to identify longitudinal changes in infants showing normal imaging findings and normal development. We also evaluated ratios of subjects with abnormal imaging findings and/or development using the 95% confidence intervals (CIs) of regression equations in normal subjects.
  
  
  RESULTS
  In the 13 infants with normal development, NAA/Cr and NAA/Cho ratios showed significant positive correlations with PCWs in the FL (r = 0.64 and 0.83, respectively, both P < 0.01) and BG + Th (r = 0.79 and 0.87, respectively, both P < 0.01), while Cho/Cr and Ins/Cr ratios revealed significant negative correlations with PCWs in the FL (r =-0.69 and -0.58, respectively, both P < 0.01) and BG + Th (r =-0.74 and -0.72, respectively, both P < 0.01). Ins/Cho ratios in the FL did not significantly correlate with PCWs (r =-0.19, P = 0.18), while those in the BG + Th showed significant negative correlation with PCWs (r =-0.44, P < 0.01). The metrics in the abnormal group were within the normal group 95% CIs in all periods except a few exceptions.
  
  
  CONCLUSIONS
  Longitudinal multivoxel MRS is able to detect temporal changes in major brain metabolites during the first year of life in preterm infants.
authors.affiliation: Department of Pediatrics, Iwate Medical University.
authors.forename: Manami
authors.initials: M
authors.lastname: Akasaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kamei
authors.forename: Nami
authors.initials: N
authors.lastname: Araya
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Yu
authors.initials: Y
authors.lastname: Konishi
authors.forename: Genichiro
authors.initials: G
authors.lastname: Sotodate
authors.forename: Satoko
authors.initials: S
authors.lastname: Shirasawa
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Toya
authors.forename: Takeo
authors.initials: T
authors.lastname: Kasai
authors.forename: Shoichi
authors.initials: S
authors.lastname: Chida
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism*; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D055442:Metabolome
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline