Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht and Utrecht University, Utrecht, Netherlands.
Department of Neonatology, Health Sciences University, Haseki Training and Research Hospital, Istanbul, Turkey.
Pediatr Res. 2022 May;91(6):1322-1333. doi: 10.1038/s41390-021-01539-x. Epub 2021 May 5.
Preterm infants are at risk of neurodevelopmental impairments. At present, proton magnetic resonance spectroscopy (H-MRS) is used to evaluate brain metabolites in asphyxiated term infants. The aim of this review is to assess associations between cerebral H-MRS and neurodevelopment after preterm birth.
PubMed and Embase were searched to identify studies using H-MRS and preterm birth. Eligible studies for this review included H-MRS of the brain, gestational age ≤32 weeks, and neurodevelopment assessed at a corrected age (CA) of at least 12 months up to the age of 18 years.
Twenty papers evaluated H-MRS in preterm infants at an age between near-term and 18 years and neurodevelopment. H-MRS was performed in both white (WM) and gray matter (GM) in 12 of 20 studies. The main regions were frontal and parietal lobe for WM and basal ganglia for GM. N-acetylaspartate/choline (NAA/Cho) measured in WM and/or GM is the most common metabolite ratio associated with motor, language, and cognitive outcome at 18-24 months CA.
NAA/Cho in WM assessed at term-equivalent age was associated with motor, cognitive, and language outcome, and NAA/Cho in deep GM was associated with language outcome at 18-24 months CA.
In preterm born infants, brain metabolism assessed using H-MRS at term-equivalent age is associated with motor, cognitive, and language outcomes at 18-24 months. H-MRS at term-equivalent age in preterm born infants may be used as an early indication of brain development. Specific findings relating to NAA were most predictive of outcome.
早产儿存在神经发育受损的风险。目前，质子磁共振波谱（H-MRS）用于评估窒息足月婴儿的脑代谢物。本综述旨在评估早产儿出生后脑 H-MRS 与神经发育之间的相关性。
在 PubMed 和 Embase 上搜索使用 H-MRS 和早产儿的研究。本综述纳入的研究需满足以下条件：H-MRS 脑成像、胎龄≤32 周、校正年龄（CA）至少 12 个月至 18 岁时进行神经发育评估。
20 篇文献评估了胎龄在接近足月至 18 岁的早产儿的 H-MRS 和神经发育情况。其中 12 项研究在白质（WM）和灰质（GM）中进行了 H-MRS 检查。主要区域为 WM 的额顶叶和 GM 的基底节。在 WM 和/或 GM 中测量的 N-乙酰天冬氨酸/胆碱（NAA/Cho）比值与 18-24 个月 CA 的运动、语言和认知结局最相关。
WM 中 NAA/Cho 在等龄时与运动、认知和语言结局相关，而 GM 深部的 NAA/Cho 与 18-24 个月 CA 的语言结局相关。
在早产儿中，H-MRS 在等龄时评估的脑代谢与 18-24 个月时的运动、认知和语言结局相关。H-MRS 在早产儿出生时等龄时的应用可能作为脑发育的早期指标。与 NAA 相关的具体发现是最具预测性的。
