Correlation between Magnetic Resonance Spectroscopy and Auditory Brain-Stem Response Audiometry in Acute Bilirubin Encephalopathy in Full Term Neonates

Background: This research aimed to correlate between MRS and ABR to see whether MRS offers new perspectives on the pathophysiology of hyperbilirubinemia and the early diagnosis of acute bilirubin encephalopathy (ABE) in full-term neonates.

Methods: This observational cohort study was done at Tanta University Hospitals between March 2019 and March 2021. It enrolled 26 newborns with ABE who were diagnosed with BIND-M score (Modified Bilirubin Induced Neurological Dysfunction Score), In addition, 20 healthy, age-matched neonates were enrolled as control subjects. Brain MRS and ABR were done to all enrolled neonates. Ethical committee approval and parent consent were taken prior to the start of the research.

Results: Regarding MRS, a significant negative correlation was detected between NAA/Cr, and NAA/Cho ratio and total plasma bilirubin levels, while only NAA/Cr had a significant positive correlation with the age on admission. On the other hand, Lac/Cr ratio had a significant positive correlation with total plasma bilirubin levels. As regards ABR, there was a significant positive correlation between wave V peak latency, I-III and I-V interpeak intervals, and bilirubin level. There were significant negative correlations between NAA/Cr and wave III peak latency, wave V peak latency, I-III, and I-V interpeak intervals. Significant negative correlations were determined between NAA/Cho and wave V peak latency, I-III, and I-V interpeak intervals. Finally, correlation between MRS and ABR revealed a significant positive correlation between Glx/Cr and I-V interpeak interval. Also, there were significant positive correlations between Lac/Cr and wave III peak latency, wave V peak latency, I-III, and I-V interpeak intervals.

Conclusion: MRS data especially NAA/Cr and Lac/Cr correlated with wave V and I-V interpeak of ABR.