title: Susceptibility weighted imaging: neuropsychologic outcome and pediatric head injury.
abstract: Traumatic brain injury is among the most frequent pediatric neurologic disorders in the United States, affecting multiple aspects of neuropsychologic functioning. This study assessed the efficacy of susceptibility weighted imaging as a predictor of long-term neuropsychologic functioning after pediatric brain injury compared with magnetic resonance spectroscopic imaging. Susceptibility weighted imaging is a relatively new method that is considered superior to traditional magnetic resonance imaging sequences for detecting hemorrhagic diffuse axonal injury. In this study, imaging and spectroscopy were acquired 6 +/- 4 days after injury. Measures of neuropsychologic functioning were administered to 18 children and adolescents 1-4 years post injury. Negative correlations between lesion number and volume with neuropsychologic functioning were demonstrated. Lesion volume explained over 32% of the variance in cognitive performance, explaining at least an additional 20% beyond injury severity and age at injury alone and 19% beyond magnetic resonance spectroscopic metabolite variables. Exploratory analyses resulted in notable trends, with lesions in deeper brain regions more strongly associated with poorer neuropsychologic performance. Improved detection of the extent of diffuse axonal injury following a brain injury will allow for a better understanding of its association with long-term outcome, which in turn can improve prognostic efficacy for effective treatment planning.
authors.affiliation: Department of Psychology, Loma Linda University, Loma Linda, California, USA.
authors.forename: Talin
authors.initials: T
authors.lastname: Babikian
authors.forename: M Catherin
authors.initials: MC
authors.lastname: Freier
authors.forename: Karen A
authors.initials: KA
authors.lastname: Tong
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Nickerson
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Wall
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Holshouser
authors.forename: Todd
authors.initials: T
authors.lastname: Burley
authors.forename: Matt L
authors.initials: ML
authors.lastname: Riggs
authors.forename: Stephen
authors.initials: S
authors.lastname: Ashwal
mesh_terms: D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000473:pathology; D020201:Brain Hemorrhage, Traumatic / Q000175:diagnosis* / Q000378:metabolism / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003401:Creatine / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007360:Intelligence; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D009483:Neuropsychological Tests; D011379:Prognosis; D012720:Severity of Illness Index
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine