Magnetic Resonance Spectroscopy at Term-equivalent Age and Executive Functions at 5 Years of Age Corrected in Very Preterm Infants

EPIRMEX is a complementary study to the national cohort EPIPAGE 2 the INSERM Unit 953 is responsible. The objective of this study is to evaluate at the age of 5 years corrected executive functions in children born very prematurely in relation to structural brain abnormalities in magnetic resonance imaging (MRI) (technical conventional and advanced) performed at the age of term. The current study is a project on a subset of the population of premature EPIRMEX subjects who had an advanced technique as magnetic resonance spectroscopy (MRS). It is a recent imaging technique for a study of the cerebral metabolism. It is based on the detection of cerebral metabolites, and the variations of their concentration to characterize different pathologies. In most cases, combinations of metabolites are informed creatine + phosphocreatine (CR), glycerophosphocholine + phosphocholine (CHO) + Nacétylaspartate Nacetylaspartylglutamate (NAA), myoinositol (INS) and lactate (LAC). In the premature newborn, the NAA / CHO ratio increases with age in all brain regions. The LAC / NAA ratio decreases significantly with age in the thalamus, basal ganglia, the corticospinal tract, and parietal white matter tends to decrease elsewhere . A number of studies show that proton spectroscopy term can predict the long-term newborn who presented an anoxic-ischemic encephalopathy .These studies indicate that an increase in lactate and a decrease in NAA are correlated with abnormal neurological development. And decreases in NAA / CR and / or NAA / CHO ratios are predictive of motor abnormalities in children with anoxic encephalopathy presented an ischemia . These decreases were also measured in the basal ganglia, occipital cortex, and areas near the last. Few studies have explored the magnetic resonance spectroscopy of proton-term prediction of the future of large premature.