支气管肺发育不良对早产儿脑 GABA 浓度的影响：前瞻性队列研究。

Impact of bronchopulmonary dysplasia on brain GABA concentrations in preterm infants: Prospective cohort study.

机构信息

Neonatology, Children's National Hospital, Washington, D.C., USA; Developing Brain Institute, Children's National Hospital, Washington, D.C., USA; The George Washington University School of Medicine, Washington, D.C., USA.

Developing Brain Institute, Children's National Hospital, Washington, D.C., USA.

出版信息

Early Hum Dev. 2023 Nov;186:105860. doi: 10.1016/j.earlhumdev.2023.105860. Epub 2023 Sep 21.

DOI:10.1016/j.earlhumdev.2023.105860

PMID:37757548

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10843009/

Abstract

BACKGROUND

Bronchopulmonary dysplasia (BPD) is associated with cognitive-behavioral deficits in very preterm (VPT) infants, often in the absence of structural brain injury. Advanced GABA-editing techniques like Mescher-Garwood point resolved spectroscopy (MEGA-PRESS) can quantify in-vivo gamma-aminobutyric acid (GABA+, with macromolecules) and glutamate (Glx, with glutamine) concentrations to investigate for neurophysiologic perturbations in the developing brain of VPT infants.

OBJECTIVE

To investigate the relationship between the severity of BPD and basal-ganglia GABA+ and Glx concentrations in VPT infants.

METHODS

MRI studies were performed on a 3 T scanner in a cohort of VPT infants [born ≤32 weeks gestational age (GA)] without major structural brain injury and healthy-term infants (>37 weeks GA) at term-equivalent age. MEGA-PRESS (TE68ms, TR2000ms, 256averages) sequence was acquired from the right basal-ganglia voxel (∼3cm) and metabolite concentrations were quantified in institutional units (i.u.). We stratified VPT infants into no/mild (grade 0/1) and moderate-severe (grade 2/3) BPD.

RESULTS

Reliable MEGA-PRESS data was available from 63 subjects: 29 healthy-term and 34 VPT infants without major structural brain injury. VPT infants with moderate-severe BPD (n = 20) had the lowest right basal-ganglia GABA+ (median 1.88 vs. 2.28 vs. 2.12 i.u., p = 0.025) and GABA+/choline (0.73 vs. 0.99 vs. 0.88, p = 0.004) in comparison to infants with no/mild BPD and healthy-term infants. The GABA+/Glx ratio was lower (0.34 vs. 0.44, p = 0.034) in VPT infants with moderate-severe BPD than in infants with no/mild BPD.

CONCLUSIONS

Reduced GABA+ and GABA+/Glx in VPT infants with moderate-severe BPD indicate neurophysiologic perturbations which could serve as early biomarkers of future cognitive deficits.

摘要

背景

支气管肺发育不良（BPD）与极早产儿（VPT）的认知行为缺陷有关，而这些缺陷通常在没有结构性脑损伤的情况下出现。先进的 GABA 编辑技术，如 Mesche-Garwood 点分辨波谱（MEGA-PRESS），可以定量检测 VPT 婴儿发育中大脑的活体 γ-氨基丁酸（GABA+，与大分子结合）和谷氨酸（Glx，与谷氨酰胺结合）浓度，以研究神经生理扰动。

目的

探讨 VPT 婴儿中 BPD 严重程度与基底节 GABA+和 Glx 浓度之间的关系。

方法

对无主要结构性脑损伤的 VPT 婴儿[出生时胎龄（GA）≤32 周]和健康足月婴儿（GA>37 周）进行 3T 扫描仪的 MRI 研究。在右基底节体素（约 3cm）中采集 MEGA-PRESS（TE68ms，TR2000ms，256 次平均）序列，并以机构单位（i.u.）定量代谢物浓度。我们将 VPT 婴儿分为无/轻度（0/1 级）和中重度（2/3 级）BPD。

结果

从 63 名受试者中获得了可靠的 MEGA-PRESS 数据：29 名健康足月婴儿和 34 名无主要结构性脑损伤的 VPT 婴儿。中重度 BPD（n=20）的 VPT 婴儿右基底节 GABA+（中位数 1.88 vs. 2.28 vs. 2.12 i.u.，p=0.025）和 GABA+/胆碱（0.73 vs. 0.99 vs. 0.88，p=0.004）最低，与无/轻度 BPD 和健康足月婴儿相比。中重度 BPD 的 VPT 婴儿 GABA+/Glx 比值较低（0.34 vs. 0.44，p=0.034）。