Acute metabolic brain changes following traumatic brain injury and their relevance to clinical severity and outcome

Silvia Marino, Ettore Zei, Marco Battaglini, Cesare Vittori, Antonella Buscalferri, Placido Bramanti, Antonio Federico, Nicola De Stefano

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Conventional MRI can provide critical information for care of patients with traumatic brain injury (TBI), but MRI abnormalities rarely correlate to clinical severity and outcome. Previous magnetic resonance spectroscopy studies have reported clinically relevant brain metabolic changes in patients with TBI. However, these changes were often assessed a few to several days after the trauma, with a consequent variation of the metabolic pattern due to temporal changes. Methods: Proton magnetic resonance spectroscopic imaging ('H-MRSI) examinations were performed in 10 patients with TBI 48-72 h after the trauma, to obtain early measurements of central brain levels of N-acetylaspartate (NAA), choline (Cho), creatine (Cr) and lactate (La). Metabolite values were expressed as ratios to (1) a metabolic pattern, given by the sum of the resonance intensities of all metabolites detected in the same voxel and (2) intravoxel Cr. Results: NAA ratios were found to be significantly lower in patients with TBI than in normal controls. In contrast, Cho ratios were significantly higher in patients with TBI than in normal controls. Increased La levels were found in 5 of 10 patients with TBI. Both NAA and La values correlated closely with those of the Glasgow Coma Scale at presentation (r = 0.73 and -0.62, respectively; p1H-MRSI is performed early after the trauma and, at this stage, can represent a reliable index of injury severity and disease outcome in patients with TBI.

Original languageEnglish
Pages (from-to)501-507
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume78
Issue number5
DOIs
Publication statusPublished - May 2007

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)
  • Psychiatry and Mental health
  • Medicine(all)

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