Division of Neonatology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Pediatr Res. 2022 Jul;92(1):299-306. doi: 10.1038/s41390-021-01434-5. Epub 2021 Mar 2.
Noninvasive advanced neuroimaging and neurochemical assessment can identify subtle abnormalities and predict neurodevelopmental impairments. Our objective was to quantify white matter metabolite levels and evaluate their relationship with neurodevelopmental outcomes at age 3 years.
Our study evaluated a longitudinal prospective cohort of very premature infants (<32 weeks gestational age) with single-voxel proton magnetic resonance spectroscopy from the centrum semiovale performed at term-equivalent age and standardized cognitive, verbal, and motor assessments at 3 years corrected age. We separately examined metabolite ratios in the left and right centrum semiovale. We also conducted an exploratory interaction analysis for high/low socioeconomic status (SES) to evaluate the relationship between metabolites and neurodevelopmental outcomes, after adjusting for confounders.
We found significant relationships between choline/creatine levels in the left and right centrum semiovale and motor development scores. Exploratory interaction analyses revealed that, for infants with low SES, there was a negative association between choline/creatine in the left centrum semiovale and motor assessment scores at age 3 years.
Brain metabolites from the centrum semiovale at term-equivalent age were associated with motor outcomes for very preterm infants at 3 years corrected age. This effect may be most pronounced for infants with low SES.
Motor development at 3 years corrected age for very preterm infants is inversely associated with choline neurochemistry within the centrum semiovale on magnetic resonance spectroscopy at term-equivalent age, especially in infants with low socioeconomic status. No prior studies have studied metabolites in the centrum semiovale to predict neurodevelopmental outcomes at 3 years corrected age based on high/low socioeconomic status. For very preterm infants with lower socioeconomic status, higher choline-to-creatine ratio in central white matter is associated with worse neurodevelopmental outcomes.
无创性高级神经影像学和神经化学评估可以识别细微异常，并预测神经发育障碍。我们的目的是定量白质代谢物水平，并评估其与 3 岁时神经发育结局的关系。
我们的研究评估了一个前瞻性纵向队列，该队列包括<32 周胎龄的非常早产儿，在足月龄时进行了单体素质子磁共振波谱检查，在 3 年校正年龄时进行了标准化认知、语言和运动评估。我们分别检查了左、右半卵圆中心的代谢物比值。我们还进行了高/低社会经济地位（SES）的探索性交互分析，以评估代谢物与神经发育结局之间的关系，在调整了混杂因素后。
我们发现左、右半卵圆中心胆碱/肌酸水平与运动发育评分之间存在显著关系。探索性交互分析显示，SES 较低的婴儿，左半卵圆中心胆碱/肌酸与 3 岁时运动评估评分之间存在负相关。
足月龄时半卵圆中心的脑代谢物与非常早产儿 3 年校正年龄时的运动结局相关。对于 SES 较低的婴儿，这种影响可能最为明显。
非常早产儿 3 年校正年龄时的运动发育与磁共振波谱足月龄时半卵圆中心的胆碱神经化学呈负相关，特别是 SES 较低的婴儿。之前没有研究研究过半卵圆中心的代谢物，以根据高/低 SES 预测 3 年校正年龄的神经发育结局。对于 SES 较低的非常早产儿，中央白质中较高的胆碱/肌酸比值与神经发育结局较差相关。
