Evaluation of traumatic brain injured patients in correlation with functional status by localized 1H-MR spectroscopy.
OBJECTIVE
To determine whether proton magnetic resonance spectroscopy (1H-MRS) could be a useful tool for detecting microscopic diffuse axonal injury to evaluate the functional status of patients with traumatic brain injury (TBI).


METHODS
A comparative study.


METHODS
An inpatient rehabilitation unit in Korea.


METHODS
We examined eight adult patients who had severe TBI approximately five months before. Fourteen normal controls were employed for comparison.


METHODS
Image-guided localized in vivo 1H-MRS was performed in the parietal white matter and occipital grey matter regions in brain in which no definite abnormalities in MR imaging were found at the time of 1H-MRS examination. We evaluated functional status for all patients with the Functional Independence Measure (FIM) on the same day as the 1H-MRS examination and compared the results.


RESULTS
In the parietal white matter, the [N-acetyl aspartate/creatine] ratios were significantly lower, and the [choline/creatine] and [myo-inositol/creatine] ratios were significantly higher than those of normal controls. Significant correlations of the IN-acetyl aspartate/creatine] and [myo-inositol/creatine] ratios in the parietal white matter with FIM scores were observed (p < 0.05).


CONCLUSIONS
A spectral feature of the decreased [N-acetyl aspartate/creatine] and increased [choline/creatine] and [myo-inositol/creatine] ratios in parietal white matter may be a marker for diffuse axonal injury in patients with TBI and has a significant correlation with the functional status of the patients. Localized 1H-MRS has the potential to be used for detecting diffuse axonal injury in vivo in TBI patients, which can be used to guide evaluation of the functional status of TBI patients receiving rehabilitation.
Yoon
Se Jin
SJ
Department of Rehabilitation Medicine, Asan Medical Center, Seoul, Korea.
Lee
Jung Hee
JH
Kim
Sang Tae
ST
Chun
Min Ho
MH
D000203:Activities of Daily Living; D000328:Adult; D001930:Brain Injuries / Q000145:classification / Q000473:pathology*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007723:Korea; D008297:Male; D019906:Nuclear Magnetic Resonance, Biomolecular; D012047:Rehabilitation Centers