Brain injury in term and preterm neonates is a serious problem. Of the approximately 42,000 infants born yearly in the United States with a birth weight less than 1500 g, approximately 85 percent survive and, of these, 5-10 percent exhibit major motor deficits and another 25-50 percent exhibit developmental and visual difficulties. Hypoxia and ischemia frequently occur during the birth process; however, the amount of brain damage in these patients and the long-term neurologic outcome varies considerably from patient to patient. There is a need, particularly in this group, to identify new clinical diagnostic tools that will improve early prediction of neurodevelopmental abnormalities and therefore allow for pharmacological interventions. The goal of this bioengineering research project is to develop and implement advanced Magnetic Resonance spectroscopic imaging techniques to detect the distribution of metabolite levels throughout the brain of neonates. Studies by ourselves and others have indicated an important role for single voxel MRS in the assessment of the neurologic status of neonates, especially premature infants and those with suspected neonatal hypoxia. However, these techniques provide very limited coverage of the brain and at poor spatial resolution. In this study, we propose to develop and optimize MRSI techniques to provide, for the first time, a study of the 3D distribution of metabolite levels in the newborn brain. This information will define the normal variation in metabolite levels with anatomic location and post-conceptional age. The database of normal MRSI spectra will improve our understanding of brain development and provide a reference for detecting abnormal metabolism in neonatal patients with neurologic damage. Current methods are inaccurate for assessing the cerebral metabolism of newborns. Through this project, we aim to develop a noninvasive metabolic imaging technique to address this important problem.
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