Impact of bronchopulmonary dysplasia on brain GABA concentrations in preterm infants: Prospective cohort study.

Early Hum Dev

Developing Brain Institute, Children's National Hospital, Washington, D.C., USA; The George Washington University School of Medicine, Washington, D.C., USA; Division of Diagnostic Imaging and Radiology, Children's National Hospital, Washington, D.C., USA; Division of Neurology, Children's National Hospital, Washington, D.C., USA. Electronic address:

Published: November 2023

AI Article Synopsis

  • Bronchopulmonary dysplasia (BPD) in very preterm infants is linked to cognitive-behavioral issues, even without visible brain damage, and advanced MRI techniques can measure brain chemicals to study these effects.
  • This study aimed to analyze how the severity of BPD affects GABA and glutamate levels in the basal ganglia of these infants.
  • Findings showed that preterm infants with moderate-severe BPD had significantly lower GABA levels compared to those with mild BPD or healthy-term infants, suggesting these measurements might help predict future cognitive challenges.

Article Abstract

Background: Bronchopulmonary dysplasia (BPD) is associated with cognitive-behavioral deficits in very preterm (VPT) infants, often in the absence of structural brain injury. Advanced GABA-editing techniques like Mescher-Garwood point resolved spectroscopy (MEGA-PRESS) can quantify in-vivo gamma-aminobutyric acid (GABA+, with macromolecules) and glutamate (Glx, with glutamine) concentrations to investigate for neurophysiologic perturbations in the developing brain of VPT infants.

Objective: To investigate the relationship between the severity of BPD and basal-ganglia GABA+ and Glx concentrations in VPT infants.

Methods: MRI studies were performed on a 3 T scanner in a cohort of VPT infants [born ≤32 weeks gestational age (GA)] without major structural brain injury and healthy-term infants (>37 weeks GA) at term-equivalent age. MEGA-PRESS (TE68ms, TR2000ms, 256averages) sequence was acquired from the right basal-ganglia voxel (∼3cm) and metabolite concentrations were quantified in institutional units (i.u.). We stratified VPT infants into no/mild (grade 0/1) and moderate-severe (grade 2/3) BPD.

Results: Reliable MEGA-PRESS data was available from 63 subjects: 29 healthy-term and 34 VPT infants without major structural brain injury. VPT infants with moderate-severe BPD (n = 20) had the lowest right basal-ganglia GABA+ (median 1.88 vs. 2.28 vs. 2.12 i.u., p = 0.025) and GABA+/choline (0.73 vs. 0.99 vs. 0.88, p = 0.004) in comparison to infants with no/mild BPD and healthy-term infants. The GABA+/Glx ratio was lower (0.34 vs. 0.44, p = 0.034) in VPT infants with moderate-severe BPD than in infants with no/mild BPD.

Conclusions: Reduced GABA+ and GABA+/Glx in VPT infants with moderate-severe BPD indicate neurophysiologic perturbations which could serve as early biomarkers of future cognitive deficits.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10843009PMC
http://dx.doi.org/10.1016/j.earlhumdev.2023.105860DOI Listing

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