title: Clinical correlations of proton magnetic resonance spectroscopy findings in acute phase after mild traumatic brain injury.
abstract: BACKGROUND
  Standard brain magnetic resonance imaging (MRI) is typically normal in most patients after mild traumatic brain injury (MTBI). Proton magnetic resonance spectroscopy (¹H-MRS) is more sensitive to detect subtle post-traumatic changes. The aim of the study was to evaluate the clinical correlations of these changes in the acute phase (within 3 days) after MTBI.
  
  
  METHODS
  Twenty-one patients with MTBI and 22 controls were studied. Both groups underwent neuropsychological testing and single-voxel ¹H-MRS examination of both frontal lobes and upper brainstem.
  
  
  RESULTS
  Significant decrease in NAA was found in both frontal lobes and in NAA/Cre ratio in the right frontal lobe (p < 0.05). Correlation analysis showed a correlation of NAA in the left frontal lobe with Backward Digit Span (p = 0.022) and Stroop test A (p = 0.0034) and a weak correlation with TMT B time (p = 0.046). The NAA/Cre in the right frontal lobe correlated with Stroop test A (p = 0.007) and with the total score of Digit Span (p = 0.016). Lower NAA was found in the upper brainstem (p = 0.0157) in the sub-group of patients with post-traumatic unconsciousness.
  
  
  CONCLUSIONS
  This study found a correlation of ¹H-MRS metabolite changes with cognitive decline and presence or absence of loss of consciousness in the acute phase after MTBI.
authors.affiliation: Clinic of Neurology .
authors.forename: Š
authors.initials: Š
authors.lastname: Sivák
authors.forename: M
authors.initials: M
authors.lastname: Bittšanský
authors.forename: J
authors.initials: J
authors.lastname: Grossmann
authors.forename: V
authors.initials: V
authors.lastname: Nosál'
authors.forename: E
authors.initials: E
authors.lastname: Kantorová
authors.forename: J
authors.initials: J
authors.lastname: Siváková
authors.forename: A
authors.initials: A
authors.lastname: Demková
authors.forename: P
authors.initials: P
authors.lastname: Hnilicová
authors.forename: D
authors.initials: D
authors.lastname: Dobrota
authors.forename: E
authors.initials: E
authors.lastname: Kurča
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001930:Brain Injuries / Q000150:complications / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D003401:Creatine / Q000378:metabolism*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D066244:Proton Magnetic Resonance Spectroscopy; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine