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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 hypoxia–ischemia (HI). Thirty infants (gestational age 27.9 ± 3.1 weeks, birth weight 1122 ± 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-cm 3  voxel in the posterior periventricular white matter (WM) using proton MRS. Intracellular pH (pH i ) 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 &lt; 0.01); lactate/Cr and pH i  were not ( P = 0.8). In the WMD group, mean lactate/Cr and myo-inositol/Cr were higher ( P &lt; 0.001, P &lt; 0.05, respectively) than the normal WM group. There was no difference in the NAA/Cr, Cho/Cr, or pH i  between the two groups, although pH i  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.

Characterization of Cerebral White Matter Damage in Preterm Infants Using 1H and 31P Magnetic Resonance Spectroscopy

Characterization of Cerebral White Matter Damage in Preterm Infants Using ¹H and ³¹P Magnetic Resonance Spectroscopy