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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:2083-2087, November-December 2006
© 2006 American Society of Neuroradiology

PEDIATRICS

Brain MR Spectroscopy Findings in Neonates with Hypothyroidism Born to Mothers Living in Iodine-Deficient Areas

A. Akinci^a, K. Sarac^b, S. Güngör^c, I. Mungan^d and Ö. Aydn^d

^a Department of Pediatric Endocrinology, nönü University, Turgut Özal Medical Center, Malatya, Turkey
^b Department of Radiology, nönü University, Turgut Özal Medical Center, Malatya, Turkey
^c Department of Pediatric Neurology,, nönü University, Turgut Özal Medical Center, Malatya, Turkey
^d Department of Pediatrics, nönü University, Turgut Özal Medical Center, Malatya, Turkey

Please address correspondence to: Aysehan Akinci, MD, nönü University, Turgut Özal Medical Center, Malatya, Turkey; e-mail: aakinci{at}inonu.edu.tr

BACKGROUND AND PURPOSE: Iodine deficiency and hypothyroxinemia have a negative effect on the development of the central nervous system during fetal and early postnatal life. MR spectroscopy is a sensitive technique for detecting the changes of brain metabolites in various neurodevelopmental disorders. By using MR spectroscopy, we aimed to show the decrease in N-acetylaspartate (NAA) levels in neonates with hypothyroidism who were born in iodine-deficient areas and its normalization with early thyroxine therapy.

METHODS: Eight congenital hypothyroid and 8 healthy full-term neonates were chosen as study and control groups, respectively. Serum thyroid hormones and median urinary iodine concentration of the neonates and their mothers were measured. Measurements of NAA, choline (Cho), and creatine (Cr) were made in frontal white matter, parietal white matter (PWM), and the thalamus with MR spectroscopy, first at 5–7 days of life and after 8 weeks of thyroxine therapy in the study group and at the same time in the control group.

RESULTS: The patient group had significantly lower NAA/Cr ratios in PWM and the thalamus (P < .05, for each), whereas the difference between Cho/Cr ratios of the 2 groups before therapy was not significant. After 8 weeks of thyroxine therapy, measurements did not show significant difference between study and control groups.

CONCLUSION: MR spectroscopy performed in neonates with hypothyroidism reveals that intrauterine hypothyroxinemia due to iodine deficiency results in significant decrease in NAA levels in PWM and the thalamus and that the normalization of NAA levels is achieved with early thyroxine therapy.