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Rajvanshi N, Bhakat R, Saxena S, Rohilla J, Basu S, Nandolia KK, Agrawal S, Bhat NK, Chacham S. Magnetic Resonance Spectroscopy in Children With Developmental Delay: Time to Look Beyond Conventional Magnetic Resonance Imaging (MRI). J Child Neurol 2021; 36:440-446. [PMID: 33305985 DOI: 10.1177/0883073820978006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Developmental delay (DD) is an important long-term neuromorbidity owing to various insults to the developing brain and neuroimaging plays a key role in evaluating these children. Magnetic resonance spectroscopy (MRS) is the only noninvasive method to determine the levels of various metabolites in the brain which aids in delineating the underlying abnormalities. A total of 48 children aged between 6 months to 6 years with developmental delay were included and evaluated with neuroimaging in our study. Sensitivity of MRS in children with DD and DD plus (DD along with seizures, abnormal motor findings, behavior, brainstem evoked response audiometry, visual assessment, and microcephaly) was 81.2% and 89.6% respectively. 86.6% of children with microcephaly had abnormal MRS. MRS detected abnormalities in two-thirds of children with normal magnetic resonance imaging (MRI). Children with behavioral abnormalities had significantly lower N-acetyl aspartate (NAA)-creatine and NAA-choline ratios on MRS. Thus, MRS is additive to MRI in delineating the underlying pathophysiology in children with DD.
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Affiliation(s)
- Nikhil Rajvanshi
- Department of Pediatrics, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rahul Bhakat
- Department of Pediatrics, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sudhir Saxena
- Department of Radio-Diagnosis & Imaging, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jitendra Rohilla
- Department of Psychiatry, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sriparna Basu
- Department of Neonatology, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Khanak Kumar Nandolia
- Department of Radio-Diagnosis & Imaging, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sonam Agrawal
- Department of Pediatrics, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nowneet Kumar Bhat
- Department of Pediatrics, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Swathi Chacham
- Department of Pediatrics, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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