McGill University Health Centre, Division of Pediatric Neurology, Montreal, PQ, Canada.
School of Physical and Occupational Therapy, McGill University, Montreal, PQ, Canada.
Sci Rep. 2017 Aug 15;7(1):8143. doi: 10.1038/s41598-017-08195-4.
This study aims to compare the cerebellar biochemical profiles in preterm (PT) infants evaluated at term equivalent age (TEA) and healthy full-term newborns using proton magnetic resonance spectroscopy (H-MRS). We explore the associations between altered cerebellar metabolite profiles and brain injury topography, severity of injury, and prematurity-related clinical complications. We prospectively collected high quality H-MRS in 59 premature infants born ≤32 weeks and 61 healthy full term controls. H-MRS data were processed using LCModel software to calculate absolute metabolite concentration for N-acetyl-aspartate (NAA), choline (Cho) and creatine (Cr). PT infants had significantly lower cerebellar NAA (p < 0.025) and higher Cho (p < 0.001) at TEA when compared to healthy controls. Creatine was not different between the two groups. The presence of cerebellar injury was consistently associated with reduced concentrations for NAA, Cho, and Cr. Postnatal infection was negatively associated with NAA and Cr (p < 005), while cerebral cortical brain injury severity was inversely associated with both Cho and Cr (p < 0.01). We report for the first time that premature birth is associated with altered cerebellar metabolite profiles when compared to term born controls. Infection, cerebellar injury and supratentorial injury are important risk factors for impaired preterm cerebellar biochemistry.
本研究旨在使用质子磁共振波谱（H-MRS）比较在胎龄相当龄（TEA）评估的早产儿（PT）和健康足月新生儿的小脑生化特征。我们探讨了改变的小脑代谢物谱与脑损伤部位、损伤严重程度以及与早产相关的临床并发症之间的关联。我们前瞻性地收集了 59 名胎龄≤32 周的早产儿和 61 名健康足月对照组的高质量 H-MRS 数据。使用 LCModel 软件处理 H-MRS 数据，以计算 N-乙酰天冬氨酸（NAA）、胆碱（Cho）和肌酸（Cr）的绝对代谢物浓度。与健康对照组相比，PT 婴儿在 TEA 时小脑 NAA（p<0.025）显著降低，Cho（p<0.001）显著升高。两组之间的肌酸没有差异。小脑损伤的存在与 NAA、Cho 和 Cr 浓度降低一致相关。与感染相比，出生后感染与 NAA 和 Cr 呈负相关（p<0.005），而大脑皮质脑损伤严重程度与 Cho 和 Cr 呈负相关（p<0.01）。我们首次报告，与足月出生的对照组相比，早产与改变的小脑代谢物谱有关。感染、小脑损伤和幕上损伤是影响早产儿小脑生化的重要危险因素。
