title: Whole-brain proton MR spectroscopic imaging of mild-to-moderate traumatic brain injury and correlation with neuropsychological deficits.
abstract: Changes in the distribution of the magnetic resonance (MR)-observable brain metabolites N-acetyl aspartate (NAA), total choline (Cho), and total creatine (Cre), following mild-to-moderate closed-head traumatic brain injury (mTBI) were evaluated using volumetric proton MR spectroscopic imaging (MRSI). Studies were carried out during the subacute time period following injury, and associations of metabolite indices with neuropsychological test (NPT) results were evaluated. Twenty-nine subjects with mTBI and Glasgow Coma Scale (GCS) scores of 10-15 were included. Differences in individual metabolite and metabolite ratio distributions relative to those of age-matched control subjects were evaluated, as well as analyses by hemispheric lobes and tissue types. Primary findings included a widespread decrease of NAA and NAA/Cre, and increases of Cho and Cho/NAA, within all lobes of the TBI subject group, and with the largest differences seen in white matter. Examination of the association between all of the metabolite measures and the NPT scores found the strongest negative correlations to occur in the frontal lobe and for Cho/NAA. No significant correlations were found between any of the MRSI or NPT measures and the GCS. These results demonstrate that significant and widespread alterations of brain metabolites occur as a result of mild-to-moderate TBI, and that these measures correlate with measures of cognitive performance.
authors.affiliation: Department of Radiology, University of Miami School of Medicine, Miami, Florida 33136, USA. VGovind@med.miami.edu
authors.forename: Varan
authors.initials: V
authors.lastname: Govind
authors.forename: Stuart
authors.initials: S
authors.lastname: Gold
authors.forename: Krithica
authors.initials: K
authors.lastname: Kaliannan
authors.forename: Gaurav
authors.initials: G
authors.lastname: Saigal
authors.forename: Steven
authors.initials: S
authors.lastname: Falcone
authors.forename: Kristopher L
authors.initials: KL
authors.lastname: Arheart
authors.forename: Leo
authors.initials: L
authors.lastname: Harris
authors.forename: Jonathan
authors.initials: J
authors.lastname: Jagid
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Maudsley
mesh_terms: D000293:Adolescent; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D001930:Brain Injuries / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D002794:Choline / Q000032:analysis / Q000378:metabolism; D003072:Cognition Disorders / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D003401:Creatine / Q000032:analysis / Q000378:metabolism; D020833:Diffuse Axonal Injury / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D015600:Glasgow Coma Scale; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000378:metabolism / Q000473:pathology; D009483:Neuropsychological Tests; D014855:Wallerian Degeneration / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline