Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2023; 12(5): 310-318
Published online Dec 9, 2023. doi: 10.5409/wjcp.v12.i5.310
Brain metabolic profile assessed by magnetic resonance spectroscopy in ‎‎children with Down syndrome: Relation to intelligence quotient
Nesreen Safwat El Feil, Heba S Elmahdy, Rasha Ahmed Elmahdy, Ahmed Abd-Elbasset Aboelezz‎, Heba S Dawoud, Mohammed Al-Beltagi
Nesreen Safwat El Feil, Heba S Elmahdy, Ahmed Abd-Elbasset Aboelezz‎, Heba S Dawoud, Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31527, Al ‎Gharbia, Egypt
Rasha Ahmed Elmahdy, Department of Radiology, University Medical Center, Dr. Sulaiman Al-Habib Medical Group‎, Manama 26671, Manama, Bahrain
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, King Abdulla Medical City, ‎Arabian Gulf University, Manama 26671, Manama, Bahrain
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, Dr. Sulaiman Al-Habib Medical Group‎, Manama 26671, Manama, Bahrain
Author contributions: Dawoud HS provided the research idea and initiated the study design; El-Feil SE and El Mahdy HS collected the patients and their information; Aboelezz AA was responsible for statistical analysis; Elshafey RA was responsible for the technical part of the study; Also, Elshafey RA oversaw imaging and data analysis; Al-Biltagi M analyzed the data and revised the manuscript. All the authors revised and agreed on the final version of the manuscript.
Institutional review board statement: We performed the study according to the latest version of Helsinki's Declaration. The Institutional Ethical and Research Review Board of Faculty of Medicine, Tanta University, approved the study.
Informed consent statement: All parents, guardians, or next of kin signed informed consent for the minors to participate in this study.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Data sharing statement: Data are available upon reasonable request.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, MSc, PhD, Academic Editor, Chairman, Consultant Physician-Scientist, Professor, Researcher, Department of Pediatrics, Faculty of Medicine, Tanta University, Al bahr street, Tanta 31527, Al ‎Gharbia, Egypt. mbelrem@hotmail.com
Received: July 17, 2023
Peer-review started: July 17, 2023
First decision: August 31, 2023
Revised: September 18, 2023
Accepted: September 28, 2023
Article in press: September 28, 2023
Published online: December 9, 2023
Processing time: 144 Days and 3.1 Hours
Abstract
BACKGROUND

Down syndrome (DS) is one of the most common causes of intellectual disability. Children with DS have varying intelligence quotient (IQ) that can predict their learning abilities.

AIM

To assess the brain metabolic profiles of children with DS and compare them to standard controls, using magnetic resonance spectroscopy (MRS) and correlating the results with IQ.

METHODS

This case-control study included 40 children with DS aged 6-15 years and 40 age and sex-matched healthy children as controls. MRS was used to evaluate ratios of choline/creatine (Cho/Cr), N-acetyl aspartic acid/creatine (NAA/Cr), and myoinositol/creatine (MI/Cr (in the frontal, temporal, and occipital lobes and basal ganglia and compared to controls and correlated with IQ.

RESULTS

Children with DS showed significant reductions in NAA/Cr and MI/Cr and a non-significant reduction in Cho/Cr in frontal lobes compared to controls. Additionally, we observed significant decreases in NAA/Cr, MI/Cr, and Cho/Cr in the temporal and occipital lobes and basal ganglia in children with DS compared to controls. Furthermore, there was a significant correlation between IQ and metabolic ratios in the brains of children with DS.

CONCLUSION

Brain metabolic profile could be a good predictor of IQ in children with DS.

Keywords: Children; Down syndrome; Magnetic resonance spectroscopy; Metabolic profile; ‎Intelligence quotient

Core Tip: This study compared the brain metabolic profiles of children with Down syndrome (DS) using magnetic resonance spectroscopy to healthy controls. The results showed significant reductions in specific metabolic ratios (N-acetyl aspartic acid/creatine and myoinositol/creatine) in the frontal lobes of children with DS compared to controls, as well as decreases in these ratios in the temporal and occipital lobes and basal ganglia. The study also found a significant correlation between intelligence quotient (IQ) and metabolic ratios in children with DS. These findings suggest that brain metabolic profiling could be a valuable predictor of IQ in children with DS.