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Phosphorus magnetic resonance spectroscopy 2 h after perinatal cerebral hypoxia‐ischemia prognosticates outcome in the newborn piglet
Author(s) -
Cady Ernest B.,
Iwata Osuke,
Bainbridge Alan,
Wyatt John S.,
Robertson Nicola J.
Publication year - 2008
Publication title -
journal of neurochemistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.75
H-Index - 229
eISSN - 1471-4159
pISSN - 0022-3042
DOI - 10.1111/j.1471-4159.2008.05662.x
Subject(s) - phosphocreatine , medicine , hypoxia (environmental) , intracellular ph , encephalopathy , inorganic phosphate , ischemia , intracellular , endocrinology , anesthesia , chemistry , energy metabolism , phosphate , biochemistry , oxygen , organic chemistry
Phosphorus magnetic resonance spectroscopy ( 31 P MRS) often reveals apparently normal brain metabolism in the first hours after intrapartum hypoxia‐ischemia (HI) at a time when conventional clinical assessment of injury severity is problematic. We aimed to elucidate very‐early, injury‐severity biomarkers. Twenty‐seven newborn piglets underwent cerebral HI: 31 P‐MRS measures ∼2 h after HI were compared between injury groups defined by secondary‐energy‐failure severity as quantified by the minimum nucleotide triphosphate (NTP) observed after 6 h. For severe and moderate injury versus baseline, [Pi]/[total exchangeable high‐energy phosphate pool (EPP)] was increased ( p < 0.001 and < 0.02, respectively), and [NTP]/[EPP] decreased ( p < 0.03 and < 0.006, respectively): severe‐injury [Pi]/[EPP] was also increased versus mild injury ( p < 0.04). Mild‐injury [phosphocreatine]/[EPP] was increased ( p < 0.004). Severe‐injury intracellular pH was alkaline versus baseline ( p < 0.002). For severe and moderate injury [total Mg]/[ATP] ( p < 0.0002 and < 0.02, respectively) and [free Mg] ( p < 0.0001 and < 0.02, respectively) were increased versus baseline. [Pi]/[EPP], [phosphocreatine]/[Pi] and [NTP]/[EPP] correlated linearly with injury severity ( p < 0.005, < 0.005 and < 0.02, respectively). Increased [Pi]/[EPP], intracellular pH and intracellular Mg ∼2 h after intrapartum HI may prognosticate severe injury, whereas increased [phosphocreatine]/[EPP] may suggest mild damage. In vivo 31 P MRS may have potential to provide very‐early prognosis in neonatal encephalopathy.