Longitudinal brain metabolic changes in birth asphyxia during the first year of life using Magnetic Resonance Spectroscopy

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K07826
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52050:Embryonic medicine and pediatrics-related
• Research Institution: Iwate Medical University
• Principal Investigator: AKASAKA MANAMI 岩手医科大学, 医学部, 准教授 (00405797)
• Co-Investigator(Kenkyū-buntansha): 亀井 淳 岩手医科大学, 医学部, 特命教授 (70275551) ; 佐々木 真理 岩手医科大学, 医歯薬総合研究所, 教授 (80205864)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 磁気共鳴分光法 / 重症仮死 / 低体温療法 / 脳内代謝物質 / 神経発達予後

Outline of Final Research Achievements

We performed 3-tesla single-voxel 1H-MRS at 38-43 postmenstrual weeks (PMW : period I) , 51-76 PMW (period II) and 85-94 PMW (period III) with 18 severe birth asphyxia infants. Eleven ainfants were treated with hypothermia. N-acetyl aspartate A, choline, Ins, glutamate＋glutamine, Creatinn, Lactate, and gamma aminobutyric acid were assessed in the basal ganglia. We assessed develpomental quotient at period Ⅲ and divided into two groups. Group A is birth asphyxia with developmental delay and group B is normal development, and group C is normal control with preterm infants. The longitudinal brain metabolites changes in group A was different the other group significantly. MRS is one of the useful tool to predict neurological outcome with birth asphyxia not only period I but also period II and III.

Free Research Field

小児神経学

Academic Significance and Societal Importance of the Research Achievements

重症仮死児の脳内代謝物質を高磁場磁気共鳴分光法（MRS)を用いて、生後12か月まで測定し、発達遅滞群、正常発達群に分類し当院早産児正常基準値と比較した。重症仮死の発達遅滞群では永続的な神経細胞障害やグリオーシスを反映し、新生児期早期のみならず、脳内代謝物の経時的変化が明らかに他群と異なることが判明した。我々は早産児の正常発達群における乳児期の経時的脳内代謝物質の計測を行い報告しているが、重症仮死児の経時的なMRS報告はなく、それを明らかにした本研究の学術的意義は大きい。低体温療法復温直後のMRSの解釈には注意が必要であり、経時的変化を見ることが発達予後予測に重要となる。