Quantitative Multivoxel Proton Spectroscopy of the Brain in Developmental Delay

Purpose: To assess whether proton MR spectroscopy of the brain in children with developmental delay reveals a consistent pattern of abnormalities. Materials and Methods: Eighty-eight patients (median age, 4.6 years; interquartile range, 3.1-8.1 years) with unexplained developmental delay, were compared with 48 normally developing age-matched controls. Patients and controls were assigned to five age-groups. Multivoxel MR spectroscopy was performed on a volume of interest superior to the lateral ventricles. The relative levels of choline, creatine, N-acetyl aspartate, and glutamate/glutamine in 24 voxels containing white matter and 12 voxels containing gray matter were quantified in an operator-independent 1 manner and expressed in proportion to the total metabolite peak area in the volume of interest. Results: White matter choline in DD showed less decrease with age. Mean choline levels, compared with mean control levels, increased from 99 to 111% with increasing age. This 1 was statistically significant in the highest age groups (P = 0.015 [7