, Volume 60, Issue 10, pp 1063–1073 | Cite as

Magnetic resonance spectroscopy in very preterm-born children at 4 years of age: developmental course from birth and outcomes

  • M.J. TaylorEmail author
  • M.M. Vandewouw
  • J.M. Young
  • D. Card
  • J.G. Sled
  • M.M. Shroff
  • C. Raybaud
Paediatric Neuroradiology



Brain metabolites show very rapid maturation over infancy, particularly following very preterm (VPT) birth, and can provide an index of brain injury. The utility of magnetic resonance imaging (MRS, magnetic resonance spectroscopy) in predicting outcome in VPT-born infants is largely limited to 2-year outcomes. We examined the value of MRS in VPT followed longitudinally to 4 years.


MRS datasets were acquired in 45 VPT infants (< 32 weeks gestational age) longitudinally: at birth, at term-equivalent and at 4 years of age. Using LCModel analyses in a basal ganglia voxel, we investigated metabolite ratios as a function of age, brain injury and outcome. We also studied a full-term (FT) cohort at 4 years and compared group differences with outcome.


We found significant age-related changes in many brain metabolites in infancy, including phosphocreatine (CR)/phosphocholine (CHO), N-acetylaspartylglutamate (NAA)/CHO, myoinositol (INS)/CHO and INS/CR; there were no significant MRS differences between VPT and FT groups at 4 years of age, or differences at 4 years as a function of early brain injury or outcome. The rate of change in metabolite ratios from VPT birth to term-equivalent age did not predict outcome in the VPT children at 4 years.


Brain metabolite ratios measured in VPT-born infants have shown associations with short-term outcomes, but these correlations did not extend to early childhood nor predict cognitive sequelae. The most frequently reported poor outcome in VPT-born children is cognitive difficulties starting at early school age. MRS metrics early in the infant’s life do not appear to predict these longer-term outcomes.


Very preterm born MRS Infants Children Outcome 



We thank all of the families who gave their time over the years to participate in this study. We also thank Tammy Rayner and Ruth Weiss for their incredible skills and help with imaging young children, Dr. Hilary Whyte and Dr. Aideen Moore for all their clinical input and recruitment efforts and Ben Morgan, Wayne Lee and Enrica Manzato for their valuable support and contributions.

Compliance with ethical standards


This study was funded by the Canadian Institutes of Health Research (MOP #84399 and #137115).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the parents of all individual participants included in the study and informed assent from the children when they were 4 years of age.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Diagnostic ImagingHospital for Sick ChildrenTorontoCanada
  2. 2.Medical ImagingUniversity of TorontoTorontoCanada
  3. 3.Neurosciences & Mental Health, Research InstituteHospital for Sick ChildrenTorontoCanada
  4. 4.PsychologyUniversity of TorontoTorontoCanada
  5. 5.Translational Medicine, Research InstituteHospital for Sick ChildrenTorontoCanada
  6. 6.Medical BiophysicsUniversity of TorontoTorontoCanada

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