Brain proton magnetic resonance spectroscopy and imaging in children exposed to cocaine in utero

Objective. The effects of prenatal cocaine exposure have been examined usin g neurobehavioral and brain structural evaluations; however, no study has e xamined the effects of prenatal cocaine on brain metabolism. Proton magneti c resonance spectroscopy (H-1-MRS) is a noninvasive method to examine the b iochemistry of various brain regions. The purpose of this study was to exam ine the possible neurotoxic effects of prenatal cocaine exposure on the dev eloping brain using H-1-MRS. Methods. Cocaine-exposed children (n = 14) and age-matched unexposed contro l participants (n = 12) were evaluated with MRI and localized H-1-MRS. Meta bolite concentrations of N-acetyl-containing compounds (NA), total creatine (Cr), choline-containing compounds, myoinositol, and glutamate + glutamine were measured in the frontal white matter and striatum. Results. Despite an absence of structural abnormalities in either group, ch ildren exposed to cocaine in utero had significantly higher Cr (+13%) in th e frontal white matter. NA, primarily a measure of N-acetyl aspartate and n euronal content, was normal in both regions examined by H-1-MRS. Normal NA suggests no significant neuronal loss or damage in the 2 brain regions exam ined in children exposed to cocaine prenatally. Conclusions. Consistent with findings in abstinent adult cocaine users, we found increased Cr in the frontal white matter, with normal NA in children exposed to cocaine. These findings suggest the need to investigate further possible abnormalities of energy metabolism in the brain of children expose d to cocaine in utero. In addition, this study demonstrates the feasibility of using 1(H)-MRS to investigate the effects of prenatal drug exposure on the developing brain.