Abstract
Purpose
To assess whether proton MR spectroscopy of the brain in children with developmental delay reveals a consistent pattern of abnormalities.
Materials and Methods
Eightyโeight patients (median age, 4.6 years; interquartile range, 3.1โ8.1 years) with unexplained developmental delay, were compared with 48 normally developing ageโmatched controls. Patients and controls were assigned to five ageโgroups. Multivoxel MR spectroscopy was performed on a volume of interest superior to the lateral ventricles. The relative levels of choline, creatine, Nโacetyl aspartate, and glutamate/glutamine in 24 voxels containing white matter and 12 voxels containing gray matter were quantified in an operatorโindependent manner and expressed in proportion to the total metabolite peak area in the volume of interest.
Results
White matter choline in DD showed less decrease with age. Mean choline levels, compared with mean control levels, increased from 99 to 111% with increasing age. This was statistically significant in the highest age groups (P = 0.015 [7 < yr โค 12.8] and P = 0.039 [12.8 < yr]). Other metabolites did not show clear alterations.
Conclusion
Proton MR spectroscopy in a group of patients with unexplained DD shows small differences in the metabolite pattern, compared with normally developing controls, that is, higher choline in the white matter. The pathophysiological origin and significance may relate to myelination and maturation of the white matter. J. Magn. Reson. Imaging 2009;30:716โ721. ยฉ 2009 WileyโLiss, Inc.