Gasparovic Charles, Caprihan Arvind, Yeo Ronald A, Phillips John, Lowe Jean R, Campbell Richard, Ohls Robin K
Mind Research Network, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Department of Psychology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Pediatr Radiol. 2018 Mar;48(3):374-382. doi: 10.1007/s00247-017-4052-1. Epub 2018 Jan 15.
Erythropoiesis stimulating agents (ESAs) are neuroprotective in cell and animal models of preterm birth. Prematurity has been shown to alter neurometabolite levels in children in studies using proton magnetic resonance spectroscopy (1H-MRS).
We hypothesized that ESA treatment in premature infants would tend to normalize neurometabolites by 4-6 years of age.
Children in a longitudinal study of neurodevelopment underwent MRI and 1H-MRS at approximately 4 years and 6 years of age. Prematurely born children (500-1,250 g birth weight) received ESAs (erythropoietin or darbepoetin) or placebo during their neonatal hospitalization, and these groups were compared to healthy term controls. 1H-MRS spectra were obtained from the anterior cingulate (gray matter) and frontal lobe white matter, assessing combined N-acetylaspartate and N-acetylaspartylglutamate (tNAA), myo-inositol, choline compounds (Cho), combined creatine and phosphocreatine, and combined glutamate and glutamine.
No significant (P≤0.5) group differences were observed for any metabolite level. Significant age-related increases in white-matter tNAA and Cho were observed, as well as a trend for increased gray-matter tNAA.
Neither prematurity nor neonatal ESA treatment was associated with differences in brain metabolite levels in the children of this study at a significance level of 0.05. These findings suggest that earlier differences that might have existed had normalized by 4-6 years of age or were too small to be statistically significant in the current sample.
促红细胞生成素（ESAs）在早产的细胞和动物模型中具有神经保护作用。在使用质子磁共振波谱（1H-MRS）的研究中，早产已被证明会改变儿童的神经代谢物水平。
我们假设对早产儿进行促红细胞生成素治疗会使4至6岁儿童的神经代谢物趋于正常。
在一项神经发育纵向研究中，儿童在大约4岁和6岁时接受了MRI和1H-MRS检查。出生体重为500-1250克的早产儿在新生儿住院期间接受了促红细胞生成素（促红细胞生成素或达贝泊汀）或安慰剂治疗，并将这些组与健康足月儿对照组进行比较。从扣带回（灰质）和额叶白质获取1H-MRS波谱，评估N-乙酰天门冬氨酸和N-乙酰天门冬氨酰谷氨酸（总NAA）、肌醇、胆碱化合物（Cho）、肌酸和磷酸肌酸以及谷氨酸和谷氨酰胺的总和。
未观察到任何代谢物水平存在显著（P≤0.5）的组间差异。观察到白质总NAA和Cho随年龄显著增加，灰质总NAA也有增加趋势。
在本研究中，无论是早产还是新生儿期促红细胞生成素治疗，在显著性水平为0.05时，均与儿童脑代谢物水平的差异无关。这些发现表明，可能曾经存在的早期差异在4至6岁时已趋于正常，或者在当前样本中太小而无统计学意义。
