1) Cerebral Phosphorus Nuclear Magnetic Resonance Spectroscopy in Perinatal Asphyxia: Our preliminary studies with in vivo 31-phosphorus nuclear magnetic resonance spectroscopy (MRS) in asphyxiated newborns suggest that there are three patterns of phosphorus metabolite changes following severe perinatal asphyxia (see report), and that these patterns correlate with neurologic prognosis. During the next year, we plan to continue our studies of asphyxiated babies by enrolling an additional 10-15 infants. MRS will be performed daily for the first 7 days. All babies will be followed with neurologic and developmental examinations at 6 months, 1 year and 2 years. With increased experience using the MRS technique and more sophisticated monitoring capabilities, we are able to study more critically ill infants. Hopefully, we will be able to add the most severely asphyxiated babies to our study group during the next year. 2) Effect of Seizures on Cerebral MRS: We have demonstrated dramatic, reversible changes in the phosphorus spectra during neonatal seizures (see report). During the coming year, we will study a more diverse group of babies with seizures. When the NIH Regional Resource Spectrometer is installed and approved for human studies, we plan to study older children with seizure disorders. 3) MRS in Pediatric Neuromuscular Disorders: Our recent study (see report) suggests that MRS may be helpful in evaluating and following children with muscular dystrophy. During the next year, we plan to continue our preliminary work by studying additional patients with Duchenne Dystrophy (n=10), Becker Dystrophy (n=10), carriers for these disorders (n=10), and repeating studies on the patients already evaluated. We have also made arrangements to study a few patients with Duchenne Dystrophy who are being treated with penicillamine. 4) Animal Model of Perinatal Asphyxia: Despite the importance of perinatal asphyxia, a good animal model of this disorder is not available. As mentioned in Section 1 and in the report, our studies in asphyxiated infants suggest that there are 3 distinct patterns of metabolic changes following perinatal asphyxia. During the next year, we will try to create these patterns in newborn puppies. If we are successful, they will be correlated with neuropathologic change.
