Early cerebral proton MRS and neurodevelopmental outcome in infants with cystic leukomalacia

• Published in: Developmental medicine and child neurology Vol. 39; no. 6; pp. 373 - 379
• Main Authors: Groenendaal, Floris, Grond, Jeroen, Eken, Paula, Haastert, Ingrid C., Rademaker, Karin J., Toet, Mona C., Vries, Linda S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.1997
• Subjects: Brain - pathology; Brain Ischemia - pathology; Developmental Disabilities; Gestational Age; Humans; Hypoxia - pathology; Infant; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Neurologic Examination
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/j.1469-8749.1997.tb07449.x

The present study tested the hypothesis that proton magnetic resonance spectroscopy CH‐MRS) predicted neurodevelopmental outcome in infants with cystic leukomalacia (CL). Nineteen infants with CL (grade 2, N‐7; grade 3, N‐7; grade 4, N=5), graded according to the authors' classification, were examined at corrected ages of mean 1.5±2.1 SD weeks. H‐MRS of the basal ganglia and the periventricular white matter was performed. Two infants died, 16 had an adverse neurodevelopmental outcome and one was normal at follow‐up. N‐acetylaspartate (NAA)‐.choline (Cho) ratios were mean 1.120.19 (SD) (grade 2), mean 0.9510.11 (SD) (grade 8), and mean 0.7110.13 (SD) (grade 4). These differences are significant (P<0.01, ANOVA). NAA: Cho ratios showed a positive correlation with developmental quotient (DQ) at the age of 1 year (P<0.05). In 13 infants lactate (Lac) was found. Lac: NAA ratios showed a negative correlation with NAA: Cho ratios, but not with DQ. We conclude that a low NAA. Cho ratio predicted a poor outcome, whereas some infants developed unfavourably despite a normal NAA: Cho ratio. We speculate that partial volume effects might explain this observation.