Relationship between opioid therapy, tissue-damaging procedures, and brain metabolites as measured by proton MRS in asphyxiated term neonates

Danilyn M. Angeles, Stephen Ashwal, Nathaniel D. Wycliffe, Charlotte Ebner, Elba Fayard, Lawrence Sowers, Barbara A. Holshouser

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

To examine the effects of opioid and tissue-damaging procedures (TDPs) [i.e. procedures performed in the neonatal intensive care unit (NICU) known to result in pain, stress, and tissue damage] on brain metabolites, we reviewed the medical records of 28 asphyxiated term neonates (eight opioid-treated, 20 non-opioid treated) who had undergone magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (MRS) within the first month of life as well as eight newborns with no clinical findings of asphyxial injury. We found that lower creatine (Cr), myoinositol (Ins), and N-acetylaspartate (NAA)/choline (Cho) (p ≤ 0.03) and higher Cho/Cr and glutamate/glutamine (Glx) Cr (p ≤ 0.02) correlated with increased TDP incidence in the first 2 d of life (DOL). We also found that occipital gray matter (OGM) NAA/Cr was decreased (p = 0.03) and lactate (Lac) was present in a significantly higher amount (40%; p = 0.03) in non-opioid-treated neonates compared with opioid-treated neonates. Compared with controls, untreated neonates showed larger changes in more metabolites in basal ganglia (BG), thalami (TH), and OGM with greater significance than treated neonates. Our data suggest that TDPs affect spectral metabolites and that opioids do not cause harm in asphyxiated term neonates exposed to repetitive TDPs in the first 2-4 DOL and may provide a degree of neuroprotection.

Original languageEnglish (US)
Pages (from-to)614-621
Number of pages8
JournalPediatric Research
Volume61
Issue number5 PART 1
DOIs
StatePublished - May 2007
Externally publishedYes

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Cell- and Tissue-Based Therapy
Creatine
Opioid Analgesics
Brain
Choline
Nociceptive Pain
Neonatal Intensive Care Units
Inositol
Basal Ganglia
Glutamine
Thalamus
Medical Records
Glutamic Acid
Lactic Acid
Magnetic Resonance Imaging
Proton Magnetic Resonance Spectroscopy
Incidence
Wounds and Injuries
Gray Matter
N-acetylaspartate

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Relationship between opioid therapy, tissue-damaging procedures, and brain metabolites as measured by proton MRS in asphyxiated term neonates. / Angeles, Danilyn M.; Ashwal, Stephen; Wycliffe, Nathaniel D.; Ebner, Charlotte; Fayard, Elba; Sowers, Lawrence; Holshouser, Barbara A.

In: Pediatric Research, Vol. 61, No. 5 PART 1, 05.2007, p. 614-621.

Research output: Contribution to journalArticle

Angeles, Danilyn M. ; Ashwal, Stephen ; Wycliffe, Nathaniel D. ; Ebner, Charlotte ; Fayard, Elba ; Sowers, Lawrence ; Holshouser, Barbara A. / Relationship between opioid therapy, tissue-damaging procedures, and brain metabolites as measured by proton MRS in asphyxiated term neonates. In: Pediatric Research. 2007 ; Vol. 61, No. 5 PART 1. pp. 614-621.
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