Creatine, Glutamine plus Glutamate, and Macromolecules Are Decreased in the Central White Matter of Premature Neonates around Term.
Creatine, Glutamine plus Glutamate, and Macromolecules Are Decreased in the Central White Matter of Premature Neonates around Term.
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肌酸，谷氨酰胺加谷氨酸和大分子在术语中的过早新生儿中央白质中减少。
DOI：
10.1371/journal.pone.0160990
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Girard N
中科院分区：
文献类型：
--
作者：
Koob M;Viola A;Le Fur Y;Viout P;Ratiney H;Confort-Gouny S;Cozzone PJ;Girard N
当早产与脑白质损伤相关时，早产代表着神经发育障碍的高风险。最近的研究报告了在相同年龄段的MRI上没有脑损伤的早产儿童的认知缺陷。了解这些缺陷的微观结构和代谢基础对于早期发现它们是至关重要的。在这里，我们使用扩散加权成像和单体素1H磁共振波谱(MRS)来比较除了弥漫性高信号外，常规MRI没有脑白质损伤证据的早产儿和正常足月新生儿在足月同龄时的脑成熟情况。研究对象为32例婴儿、16例足月新生儿(扫描时平均孕周为39.8±1周)和16例早产儿(出生时平均孕周为29.1±2周，扫描时平均孕周为39.2±1周)。MRI/MRS检查采用1.5T磁共振扩散加权成像，1H-MRS采用点分辨波谱(PRESS)序列定位。早产儿颞叶白质(P<；0.005)、枕叶白质(P<；0.005)和丘脑(P<；0.05)的ADC值显著高于对照组。早产儿半卵圆中心的质子谱特征是30ms时牛磺酸/H2O和大分子/H2O比值(P<；0.05)显著低于足月儿，135ms时(肌酸+磷酸肌酸)/H2O和(谷氨酰胺+谷氨酸)/H2O比值(P<；0.05)明显低于足月儿。我们的研究结果表明，常规MRI正常的早产儿大脑成熟延迟，影响脑白质和丘脑。他们的大脑代谢特征是肌酸、谷氨酰胺和谷氨酸水平较低，以及半卵圆中心的大分子，这一发现表明能量代谢和蛋白质合成发生了变化。
Preterm birth represents a high risk of neurodevelopmental disabilities when associated with white-matter damage. Recent studies have reported cognitive deficits in children born preterm without brain injury on MRI at term-equivalent age. Understanding the microstructural and metabolic underpinnings of these deficits is essential for their early detection. Here, we used diffusion-weighted imaging and single-voxel 1H magnetic resonance spectroscopy (MRS) to compare brain maturation at term-equivalent age in premature neonates with no evidence of white matter injury on conventional MRI except diffuse excessive high-signal intensity, and normal term neonates. Thirty-two infants, 16 term neonates (mean post-conceptional age at scan: 39.8±1 weeks) and 16 premature neonates (mean gestational age at birth: 29.1±2 weeks, mean post-conceptional age at scan: 39.2±1 weeks) were investigated. The MRI/MRS protocol performed at 1.5T involved diffusion-weighted MRI and localized 1H-MRS with the Point RESolved Spectroscopy (PRESS) sequence. Preterm neonates showed significantly higher ADC values in the temporal white matter (P<0.05), the occipital white matter (P<0.005) and the thalamus (P<0.05). The proton spectrum of the centrum semiovale was characterized by significantly lower taurine/H2O and macromolecules/H2O ratios (P<0.05) at a TE of 30 ms, and reduced (creatine+phosphocreatine)/H2O and (glutamine+glutamate)/H2O ratios (P<0.05) at a TE of 135 ms in the preterm neonates than in full-term neonates. Our findings indicate that premature neonates with normal conventional MRI present a delay in brain maturation affecting the white matter and the thalamus. Their brain metabolic profile is characterized by lower levels of creatine, glutamine plus glutamate, and macromolecules in the centrum semiovale, a finding suggesting altered energy metabolism and protein synthesis.