Non-invasive measurement of biochemical profiles in the healthy fetal brain

Subechhya Pradhan; Kushal Kapse; Marni Jacobs; Nickie Niforatos-Andescavage; Jessica Lynn Quistorff; Catherine Lopez; Kathryn Lee Bannantine; Nicole Reinholdt Andersen; Gilbert Vezina; Catherine Limperopoulos

NeuroImage (Oct 2020)

Non-invasive measurement of biochemical profiles in the healthy fetal brain

Subechhya Pradhan,
Kushal Kapse,
Marni Jacobs,
Nickie Niforatos-Andescavage,
Jessica Lynn Quistorff,
Catherine Lopez,
Kathryn Lee Bannantine,
Nicole Reinholdt Andersen,
Gilbert Vezina,
Catherine Limperopoulos

Affiliations

Subechhya Pradhan: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA; Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC, 20010, USA; Department of Radiology, The George Washington University School of Medicine, Washington, DC, 20052, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, 20052, USA
Kushal Kapse: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA
Marni Jacobs: Department of Biostatistics and Study Methodology, Children’s Research Institute, Children’s National Hospital, Washington, DC, 20010, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, CA, 92093, USA
Nickie Niforatos-Andescavage: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, 20052, USA; Division of Neonatology, Children’s National Hospital, Washington, DC, 20010, USA
Jessica Lynn Quistorff: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA
Catherine Lopez: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA
Kathryn Lee Bannantine: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA
Nicole Reinholdt Andersen: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA
Gilbert Vezina: Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC, 20010, USA
Catherine Limperopoulos: Center for the Developing Brain, Children’s National Hospital, Washington, DC, 20010, USA; Department of Diagnostic Imaging and Radiology, Children’s National Hospital, Washington, DC, 20010, USA; Department of Radiology, The George Washington University School of Medicine, Washington, DC, 20052, USA; Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, 20052, USA; Corresponding author. 111 Michigan Ave NW, Washington, DC, 20010, USA.

Journal volume & issue: Vol. 219
p. 117016

Abstract

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Proton magnetic resonance spectroscopy (1H-MRS) of the fetal brain can be used to study emerging metabolite profiles in the developing brain. Identifying early deviations in brain metabolic profiles in high-risk fetuses may offer important adjunct clinical information to improve surveillance and management during pregnancy. Objective: To investigate the normative trajectory of the fetal brain metabolites during the second half of gestation, and to determine the impact of using different Cramer-Rao Lower Bounds (CRLB) threshold on metabolite measurements using magnetic resonance spectroscopy. Study design: We prospectively enrolled 219 pregnant women with normal fetal ultrasound and biometric measures. We performed a total of 331 fetal 1H-MRS studies with gestational age in the rage of 18–39 weeks with 112 of the enrolled participants scanned twice. All the spectra in this study were acquired on a GE 1.5 T scanner using long echo-time of 144 ms and analyzed in LCModel. Results: We successfully acquired and analyzed fetal 1H-MRS with a success rate of 93%. We observed increases in total NAA, total creatine, total choline, scyllo inositol and total NAA-to-total choline ratio with advancing GA. Our results also showed faster increases in total NAA and total NAA-to-total choline ratio during the third trimester compared to the second trimester. We also observed faster increases in total choline and total NAA in female fetuses. Increasing the Cramer-Rao lower bounds threshold progressively from 100% to 40%–20% increased the mean metabolite concentrations and decreased the number of observations available for analysis. Conclusion: We report serial fetal brain biochemical profiles in a large cohort of health fetuses studied twice in gestation with a high success rate in the second and third trimester of pregnancy. We present normative in-vivo fetal brain metabolite trajectories over a 21-week gestational period which can be used to non-invasively measure and monitor brain biochemistry in the healthy and high-risk fetus.

Published in NeuroImage

ISSN: 1053-8119 (Print); 1095-9572 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/neuroimage

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