Increased detectability of alpha brain glutamate/glutamine in neonatal hypoxic-ischemic encephalopathy

Yonglin Pu, Qing Feng Li, Chao Mei Zeng, Jian Gao, Jing Qi, De Xin Luo, Srikanth Mahankali, Peter T. Fox, Jia Hong Gao

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61 Scopus citations

Abstract

BACKGROUND AND PURPOSE: Proton MR spectroscopy (MRS) detectability of brain glutamate/glutamine (Glx) is increased in hypoxic-ischemic insults and is implicated in the neuronal injury and death that follows. Our aim was to correlate the proton MRS detectability of α-CH protons of Glx (α-Glx) with the Sarnat stage of neonatal hypoxic-ischemic encephalopathy (HIE). METHODS: Initial and follow-up proton MRS studies at 1.9 T were performed in 28 neonates aged 1 to 7 days (seven healthy control subjects and 21 with HIE: 10 mild, nine moderate, and two severe) and in 12 neonates aged 13 to 17 days (12 with HIE: eight mild, three moderate, and one severe), respectively. Both point-resolved spectroscopy (PRESS) and stimulated-echo acquisition mode (STEAM) sequences were used. The spectral volume of interest was in the basal ganglia, thalami, and adjoining regions. The detectability of α-Glx was assessed by two different parameters: the detection rate of the α-Glx peak and the peak-area ratio of α-Glx to creatine and phosphocreatine. RESULTS: On both the initial and follow-up PRESS studies, all the neonates with moderate and severe HIE showed an α-Glx peak, compared with one healthy control subject in the initial study and one neonate with mild HIE in both the studies. They also demonstrated a significantly higher peak-area ratio of α-Glx/(creatine and phosphocreatine) on both the initial and follow-up studies. The peak-area ratios in neonates with HIE positively correlated with the Sarnat stage of HIE on both the initial and follow-up studies. Neonates with moderate and severe HIE also showed a consistently higher α-Glx peak on both the initial and follow-up studies with the STEAM sequence. CONCLUSION: Proton MRS detectability of α-Glx is increased in moderate and severe HIE and correlates with the Samat stage of HIE.

Original languageEnglish (US)
Pages (from-to)203-212
Number of pages10
JournalAmerican Journal of Neuroradiology
Volume21
Issue number1
StatePublished - May 9 2000

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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    Pu, Y., Li, Q. F., Zeng, C. M., Gao, J., Qi, J., Luo, D. X., Mahankali, S., Fox, P. T., & Gao, J. H. (2000). Increased detectability of alpha brain glutamate/glutamine in neonatal hypoxic-ischemic encephalopathy. American Journal of Neuroradiology, 21(1), 203-212.