Smith L M, Chang L, Yonekura M L, Gilbride K, Kuo J, Poland R E, Walot I, Ernst T
Department of Pediatrics, Harbor-University of California, Los Angeles Medical Center, Torrance, CA 90502, USA.
Pediatrics. 2001 Feb;107(2):227-31. doi: 10.1542/peds.107.2.227.
The effects of prenatal cocaine exposure have been examined using neurobehavioral and brain structural evaluations; however, no study has examined the effects of prenatal cocaine on brain metabolism. Proton magnetic resonance spectroscopy ((1)H-MRS) is a noninvasive method to examine the biochemistry of various brain regions. The purpose of this study was to examine the possible neurotoxic effects of prenatal cocaine exposure on the developing brain using (1)H-MRS.
Cocaine-exposed children (n = 14) and age-matched unexposed control participants (n = 12) were evaluated with MRI and localized (1)H-MRS. Metabolite concentrations of N-acetyl-containing compounds (NA), total creatine (Cr), choline-containing compounds, myoinositol, and glutamate + glutamine were measured in the frontal white matter and striatum.
Despite an absence of structural abnormalities in either group, children exposed to cocaine in utero had significantly higher Cr (+13%) in the frontal white matter. NA, primarily a measure of N-acetyl aspartate and neuronal content, was normal in both regions examined by (1)H-MRS. Normal NA suggests no significant neuronal loss or damage in the 2 brain regions examined in children exposed to cocaine prenatally.
Consistent with findings in abstinent adult cocaine users, we found increased Cr in the frontal white matter, with normal NA in children exposed to cocaine. These findings suggest the need to investigate further possible abnormalities of energy metabolism in the brain of children exposed to cocaine in utero. In addition, this study demonstrates the feasibility of using (1)H-MRS to investigate the effects of prenatal drug exposure on the developing brain.
已通过神经行为和脑结构评估来研究产前接触可卡因的影响；然而，尚无研究考察产前接触可卡因对脑代谢的影响。质子磁共振波谱（(1)H-MRS）是一种用于检查不同脑区生物化学的非侵入性方法。本研究的目的是使用(1)H-MRS来考察产前接触可卡因对发育中大脑可能产生的神经毒性作用。
对接触可卡因的儿童（n = 14）和年龄匹配的未接触可卡因的对照参与者（n = 12）进行MRI和局部(1)H-MRS评估。测量额叶白质和纹状体中含N-乙酰基化合物（NA）、总肌酸（Cr）、含胆碱化合物、肌醇以及谷氨酸+谷氨酰胺的代谢物浓度。
尽管两组均未发现结构异常，但子宫内接触可卡因的儿童额叶白质中的Cr显著更高（升高13%）。通过(1)H-MRS检查的两个区域中，主要作为N-乙酰天门冬氨酸和神经元含量指标的NA均正常。NA正常表明产前接触可卡因的儿童所检查的两个脑区未出现明显的神经元丢失或损伤。
与成年可卡因戒除者的研究结果一致，我们发现接触可卡因的儿童额叶白质中Cr升高，而NA正常。这些发现表明有必要进一步研究子宫内接触可卡因的儿童大脑能量代谢可能存在的异常。此外，本研究证明了使用(1)H-MRS来研究产前药物暴露对发育中大脑影响的可行性。
