MR spectroscopy: predicting long-term neuropsychological outcome following pediatric TBI.
OBJECTIVE
To identify useful acute indicators of long-term neurocognitive outcome beyond clinical variables for children and adolescents treated for a traumatic brain injury (TBI).


METHODS
The efficacy of magnetic resonance spectroscopy (MRS) acquired 6+/-4 days after TBI in 20 children/adolescents in predicting intellectual and neuropsychological functioning one to four years post injury was assessed. Short echo-time single voxel MRS (SVS) from normal-appearing brain was compared to intermediate echo-time multivoxel MR spectroscopic imaging (MRSI) from normal-appearing and visibly-injured brain acquired through the level of the corpus callosum (CC).


RESULTS
N-acetyl aspartate (NAA) was moderate to strongly correlated with cognitive scores. Mean NAA/creatine (Cre) from MRSI alone explained over 40% of the variance in cognitive scores and 18% of the variance above and beyond demographic and clinical variables alone. Mild to moderate associations were noted between SVS metabolites (glutamate/glutamine [Glx] and myoinositol [mI]) and cognitive scores, with no such associations apparent for choline (Cho) or Cre. Exploratory analyses revealed trends for regional neuroimaging data and specific cognitive abilities.


CONCLUSIONS
Acute MR spectroscopy of the pediatric brain injury patient improves prognostic ability and may provide valuable information for early treatment and intervention planning.
Babikian
Talin
T
Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles (UCLA) School of Medicine, Los Angeles, California 90024, USA. tbabikian@mednet.ucla.edu
Freier
M Catherin
MC
Ashwal
Stephen
S
Riggs
Matt L
ML
Burley
Todd
T
Holshouser
Barbara A
BA
D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001930:Brain Injuries / Q000378:metabolism / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003401:Creatine / Q000378:metabolism; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D007223:Infant; D007294:Inositol / Q000378:metabolism; D016014:Linear Models; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D020127:Recovery of Function; D018709:Statistics, Nonparametric
D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine