A correlation between Magnetic Resonance Spectroscopy (1-H MRS) and the neurodevelopment of two-year-olds born preterm in an EPIRMEX cohort study

Catherine Gire; Julie Berbis; Marion Dequin; Stéphane Marret; Jean-Baptiste Muller; Elie Saliba; Barthélémy Tosello

doi:10.3389/fped.2022.936130

A correlation between Magnetic Resonance Spectroscopy (1-H MRS) and the neurodevelopment of two-year-olds born preterm in an EPIRMEX cohort study

Front Pediatr. 2022 Aug 19:10:936130. doi: 10.3389/fped.2022.936130. eCollection 2022.

Authors

Catherine Gire^{1

2}, Julie Berbis², Marion Dequin³, Stéphane Marret³, Jean-Baptiste Muller⁴, Elie Saliba⁵, Barthélémy Tosello^{1

6}

Affiliations

¹ Department of Neonatal Medicine, Assistance Publique Hopitaux de Marseille, Marseille, France.
² EA3279, Faculty of Medicine, Self-Perceived Health Assessment Research Unit, Marseille, France.
³ Department of Neonatal Pediatrics, Intensive Care, and Neuropediatrics, Rouen University Hospital and Institut National de la Santé et de la Recherche Médicale INSERM U 1245 Team 4 Neovasc, School of Medicine, Normandy University, Rouen, France.
⁴ Department of Neonatal Medicine, Nantes University Hospital, Nantes, France.
⁵ UMR 1253, iBrain, Tours University, Institut National de la Santé et de la Recherche Médicale (INSERM), Tours, France.
⁶ Aix-Marseille University, CNRS, EFS, ADES, Marseille, France.

Abstract

Background: Preterm infants are at risk of neurodevelopmental impairments. At present, proton magnetic resonance spectroscopy (1H-MRS) is currently used to evaluate brain metabolites in asphyxiated term infants. The purpose of this study was to identify in the preterm EPIRMEX cohort any correlations between (1H-MRS) metabolites ratio at term equivalent age (TEA) and neurodevelopmental outcomes at 2 years.

Methods: Our study included EPIRMEX eligible patients who were very preterm infants (gestational age at birth ≤32 weeks) and who underwent a brain MRI at TEA and ¹H-MRS using a monovoxel technique. The volumes of interest (VOI) were periventricular white matter posterior area and basal ganglia. The ratio of N Acetyl Aspartate (NAA) to Cho (Choline), NAA to Cr (creatine), Cho to Cr, and Lac (Lactate) to Cr were measured. Neurodevelopment was assessed at 24 months TEA with ASQ (Ages and Stages Questionnaire).

Results: A total of 69 very preterm infants had a 1H-MRS at TEA. In white matter there was a significant correlation between a reduction in the NAA/Cho ratio and a total ASQ and/or abnormal communication score, and an increase in the Lac/Cr ratio and an abnormality of fine motor skills. In the gray nuclei there was a trend correlation between the reduction in the NAA/Cho ratio and sociability disorders; and the increase in the Lac/Cr ratio and an anomaly in problem-solving.

Conclusions: Using NAA as a biomarker, the vulnerability of immature oligodendrocytes in preterm children at TEA was correlated to neurodevelopment at 2 years. Similarly, the presence of lactate at TEA was associated with abnormal neurodevelopment at 2 years in the preterm brain.

Keywords: 2 years follow-up; magnetic resonance spectroscopy; morbidity; neurodevelopmental outcome; very preterm infant.