Characterization of cerebral white matter damage in preterm infants using 1H and 31P magnetic resonance spectroscopy

N J Robertson, J Kuint, T J Counsell, T A Rutherford, A Coutts, I J Cox, A D Edwards

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

The biochemical characteristics of white matter damage (WMD) in preterm infants were assessed using magnetic resonance spectroscopy (MRS). The authors hypothesized that preterm infants with WMD at term had a persisting cerebral lactic alkalosis and reduced N-acetyl aspartate (NAA)/ creatine plus phosphocreatine (Cr), similar to that previously documented in term infants weeks after perinatal hypoxiaischemia (HI). Thirty infants (gestational age 27.9 +/- 3.1 weeks, birth weight 1,122 +/- 445 g) were studied at postnatal age of 9.8 +/- 4.1 weeks (corrected age 40.3 +/- 3.9 weeks). Infants were grouped according to the presence or absence of WMD on magnetic resonance (MR) images. The peak area ratios of lactate/Cr, NAA/Cr, myo-inositol/Cr, and choline (Cho)/Cr were measured from an 8-cm3 voxel in the posterior periventricular white matter (WM) using proton MRS. Intracellular pH (pHi) was calculated using phosphorus MRS. Eighteen infants had normal WM on MR imaging; 12 had WMD. For infants with WMD, lactate/Cr and myo-inositol/Cr were related (P < 0.01); lactate/Cr and pHi were not (P = 0.8). In the WMD group, mean lactate/Cr and myo-inositol/Cr were higher (P < 0.001, P < 0.05, respectively) than the normal WM group. There was no difference in the NAA/Cr, Cho/Cr, or pHi between the two groups, although pHi was not measured in all infants. These findings suggest that WMD in the preterm infant at term has a different biochemical profile compared with the term infant after perinatal HI.

Original languageEnglish
Pages (from-to)1446-56
Number of pages11
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number10
Publication statusPublished - Oct 2000

Keywords / Materials (for Non-textual outputs)

  • Brain/metabolism
  • Creatine/metabolism
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Inositol/metabolism
  • Lactic Acid/metabolism
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Male
  • Phosphocreatine/metabolism
  • Phosphorus
  • Prospective Studies
  • Protons
  • Reference Values


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