Elucidating Metabolic Maturation in the Healthy Fetal Brain Using1H-MR Spectroscopy
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BACKGROUND AND PURPOSE: (1)H-MRS provides a noninvasive way to study fetal brain maturation at the biochemical level. The purpose of this study was to characterize in vivo metabolic maturation in the healthy fetal brain during the second and third trimester using (1)H-MRS. MATERIALS AND METHODS: Healthy pregnant volunteers between 18 and 40 weeks gestational age underwent single voxel (1)H-MRS. MR spectra were retrospectively corrected for motion-induced artifacts and quantified using LCModel. Linear regression was used to examine the relationship between absolute metabolite concentrations and ratios of total NAA, Cr, and Cho to total Cho and total Cr and gestational age. RESULTS: Two hundred four spectra were acquired from 129 pregnant women at mean gestational age of 30.63 ± 6 weeks. Total Cho remained relatively stable across the gestational age (r(2) = 0.04, P = .01). Both total Cr (r(2) = 0.60, P < .0001) as well as total NAA and total NAA to total Cho (r(2) = 0.58, P < .0001) increased significantly between 18 and 40 weeks, whereas total NAA to total Cr exhibited a slower increase (r(2) = 0.12, P < .0001). Total Cr to total Cho also increased (r(2) = 0.53, P < .0001), whereas total Cho to total Cr decreased (r(2) = 0.52, P < .0001) with gestational age. The cohort was also stratified into those that underwent MRS in the second and third trimesters and analyzed separately. CONCLUSIONS: We characterized metabolic changes in the normal fetal brain during the second and third trimesters of pregnancy and derived normative metabolic indices. These reference values can be used to study metabolic maturation of the fetal brain in vivo.
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Advanced MRI and 1H-MRS techniques can be successfully applied to the living fetus.
“The successful applications of advanced magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS) techniques to the living fetus30,31,32 provide an unprecedented opportunity to study the association between maternal psychological distress and human fetal brain development.”
From Association of prenatal maternal psychological distress with fetal brain growth, metabolism, and cortical maturation. (2020) · cites this paper as [32]
8% of MRI scans and 19% of 1H-MRS scans were lost due to severe fetal motion or unsuccessful acquisition, similar to or better than other fetal MRI studies.
“8% of the MRI scans could not be used because of severe fetal motion and 19% of 1H-MRS scans were not successfully obtained; however, the percentage of lost data in this study is still similar or superior to that in other fetal MRI studies.”
From Association of prenatal maternal psychological distress with fetal brain growth, metabolism, and cortical maturation. (2020) · cites this paper as [32]
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“Metabolic alterations in the in utero fetal brain have been shown to precede morphologic brain changes [104] and may provide new insights into the mechanisms that underlie impairments to fetal brain development concerning prenatal maternal psychological distress [105].”
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Self-citation
- Authors
- Evangelou, I. E., du Plessis, A. J., Vezina, G., Noeske, R., & Limperopoulos, C.
- Affiliations
- George Washington University (US)
- Children's National (US)
- Venue
- American Journal of Neuroradiology
- Published
- 2015-09-24
- Volume
- 37
- Issue
- 2
- Pages
- 360-366
- ISSN
- 0195-6108 (ISSN-L)
- 1936-959X
- PMC
- PMC7959935
- OpenAlex
- W1904095712
- Cited by
- 37
- References
- 50
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 1
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- American Journal of Neuroradiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Defense
- U.S. Department of Veterans Affairs
- Canadian Institutes of Health Research (81116_1)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolomics and Mass Spectrometry Studies
- Keywords
- fetal brain maturation, fetal brain metabolism, gestational age, N-acetylaspartate, choline, creatine, metabolite ratios, reference values, second and third trimester
- MeSH terms
- Adult, Aspartic Acid, Brain, Choline, Creatine, Female, Fetus, Gestational Age, Humans, Pregnancy, Reference Values, Fetal Development, Proton Magnetic Resonance Spectroscopy
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