Steger, Céline; Feldmann, Maria; Borns, Julia; Hagmann, Cornelia; Latal, Beatrice; Held, Ulrike; Jakab, András; O'Gorman Tuura, Ruth; Knirsch, Walter (2023). Neurometabolic changes in neonates with congenital heart defects and their relation to neurodevelopmental outcome. Pediatric research, 93(6), pp. 1642-1650. Nature Publishing Group 10.1038/s41390-022-02253-y
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BACKGROUND
Altered neurometabolite ratios in neonates undergoing cardiac surgery for congenital heart defects (CHD) may serve as a biomarker for altered brain development and neurodevelopment (ND).
METHODS
We analyzed single voxel 3T PRESS H1-MRS data, acquired unilaterally in the left basal ganglia and white matter of 88 CHD neonates before and/or after neonatal cardiac surgery and 30 healthy controls. Metabolite ratios to Creatine (Cr) included glutamate (Glu/Cr), myo-Inositol (mI/Cr), glutamate and glutamine (Glx/Cr), and lactate (Lac/Cr). In addition, the developmental marker N-acetylaspartate to choline (NAA/Cho) was evaluated. All children underwent ND outcome testing using the Bayley Scales of Infant and Toddler Development Third Edition (BSID-III) at 1 year of age.
RESULTS
White matter NAA/Cho ratios were lower in CHD neonates compared to healthy controls (group beta estimate: -0.26, std. error 0.07, 95% CI: -0.40 - 0.13, p value <0.001, FDR corrected p value = 0.010). We found no correlation between pre- or postoperative white matter NAA/Cho with ND outcome while controlling for socioeconomic status and CHD diagnosis.
CONCLUSION
Reduced white matter NAA/Cho in CHD neonates undergoing cardiac surgery may reflect a delay in brain maturation. Further long-term MRS studies are needed to improve our understanding of the clinical impact of altered metabolites on brain development and outcome.
IMPACT
NAA/Cho was reduced in the white matter, but not the gray matter of CHD neonates compared to healthy controls. No correlation to the 1-year neurodevelopmental outcome (Bayley-III) was found. While the rapid change of NAA/Cho with age might make it a sensitive marker for a delay in brain maturation, the relationship to neurodevelopmental outcome requires further investigation.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Borns, Julia |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0031-3998 |
Publisher: |
Nature Publishing Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
24 Aug 2022 10:12 |
Last Modified: |
12 May 2023 00:11 |
Publisher DOI: |
10.1038/s41390-022-02253-y |
PubMed ID: |
35995938 |
BORIS DOI: |
10.48350/172340 |
URI: |
https://boris.unibe.ch/id/eprint/172340 |
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