title: Predicting neuropsychologic outcome after traumatic brain injury in children.
abstract: The ability to predict long-term neurologic and neuropsychologic outcomes in 22 children, ages 1 week to 14 years at the time of traumatic brain injury, was investigated using proton magnetic resonance spectroscopy acquired post injury and compared with standardized neurologic, intellectual, and neuropsychologic testing done 1-7 years later. Clinical indicators of acute injury severity including age at injury, electroencephalography, spectroscopy metabolite ratio variables (N-acetyl aspartate/choline, choline/creatine) and lactate presence accurately classified children as functioning above or below the average range for most intellectual and neuropsychologic outcome measures. Combined clinical and spectroscopy variables accounted for approximately 50% of the variance in cognitive and neuropsychologic outcome confirming the validity of their predictive use. Of the injury severity indictors, presence of lactate is a particularly important prognostic marker of poor long-term intellectual and neuropsychologic functioning. Our findings indicate the potential for providing accurate estimates of long-term intellectual and neuropsychologic function after traumatic brain injury in infants and children using proton magnetic resonance spectroscopy in combination with clinical variables.
authors.affiliation: Department of Psychology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
authors.forename: Tamara
authors.initials: T
authors.lastname: Brenner
authors.forename: M Catherin
authors.initials: MC
authors.lastname: Freier
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Holshouser
authors.forename: Todd
authors.initials: T
authors.lastname: Burley
authors.forename: Stephen
authors.initials: S
authors.lastname: Ashwal
mesh_terms: D000293:Adolescent; D000328:Adult; D001923:Brain Chemistry; D001930:Brain Injuries / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D006801:Humans; D007361:Intelligence Tests; D019344:Lactic Acid / Q000032:analysis; D009682:Magnetic Resonance Spectroscopy; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D016896:Treatment Outcome
chemical_list: D019344:Lactic Acid