Application value of multivoxel magnetic resonance spectroscopy in assessing changes in cerebral metabolite levels in children with autism spectrum disorder treated with umbilical cord blood mononuclear cells

LI Zhijuan; LI Xiaotong; ZHANG Cong; GAO Duo; WANG Xiuxia; TIAN Xiaoyu; QIAO Guirong; GU Leilei; ZHOU Lixia

doi:10.3969/j.issn.1002-3429.2025.23.017

Abstract：Objective To investigate the changes in cerebral biochemical metabolite levels of children with autism spectrum disorder(ASD)before and after treatment with umbilical cord blood mononuclear cells(UCB-MNC)and their correlation with the changes in the Childhood Autism Rating Scale(CARS)scores.Methods Multivoxel magnetic resonance spectroscopy(MRS)was used to conduct spectral analysis on 20 children aged 3 to 8 years with ASD who were admitted from August 2021 to July 2022 before UCB-MNC treatment and at 3 to 12 months after treatment.Changes in N-acetylaspartic acid(NAA),choline(Cho),and creatine(Cr)metabolites in different brain regions were compared,and the correlation between the changes in metabolites and the changes of CARS scores was analyzed.Results After UCB-MNC treatment,among the 20 children with ASD,there was decreased CARS scores in 17 patients,no significant change in 1 patient,and slight increase in 2 patients.The CARS scores of 20 children with ASD after treatment were lower than those before treatment(P<0.01).MRS revealed that the NAA levels in the bilateral frontal lobes,bilateral cerebellar hemispheres,bilateral dorsal thalamus and other brain regions of 17 children with ASD were significantly increased compared with those before treatment(P<0.05,P<0.01),and the changes in NAA levels in the bilateral frontal lobes and bilateral dorsal thalamus were negatively correlated with the changes in CARS scores(P<0.01).The changes in NAA levels in both cerebellar hemispheres were not significantly associated with changes in CARS scores(P>0.05).The Cho level in the right dorsal thalamus was significantly increased in 19(95%)children with ASD(P<0.05),and the Cr level in the left frontal lobe was significantly increased in 17(85%)children with ASD(P<0.05);there was no significant correlation between the changes in the levels of the above two indicators and the changes in CARS scores(P>0.05).No significant changes in the levels of the above metabolite levels were found in the other brain regions such as the parietal lobe,occipital lobe,hippocampus and amygdala.Conclusion In the early stage of UCB-MNC treatment,alterations in certain brain metabolites are observed in the majority of children with ASD,which is correlated with the improvement of clinical symptoms.UCB-MNC has a positive effect on the treatment of children with ASD,and MRS has important reference value in the evaluation of its therapeutic effect.