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Chapter 43 - Magnetic resonance spectroscopy in traumatic brain injury

from Section 7 - Trauma

Published online by Cambridge University Press:  05 March 2013

By
William M. Brooks  and
Barbara A. Holshouser
Edited by
Jonathan H. Gillard ,
Adam D. Waldman  and
Peter B. Barker
Jonathan H. Gillard
Affiliation:
University of Cambridge
Adam D. Waldman
Affiliation:
Imperial College London
Peter B. Barker
Affiliation:
The Johns Hopkins University School of Medicine
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Summary

Introduction

Traumatic brain injury (TBI) affects approximately 1.5 million people in the USA annually, is the leading cause of death in patients under the age of 45, and has an annual mortality rate of at least 20 per 100 000.[1–3] The long-term impact of TBI is extreme, and even patients with mild or moderate brain injury suffer lingering effects, including impaired cognitive function and increased medical and social costs.[4]

Reliable methods for assessing injury severity and predicting patient outcome soon after injury would improve overall clinical management and evaluation of pharmaceutical interventions. Injury severity is commonly measured using the Glasgow Coma Scale (GCS) or the duration of post-traumatic amnesia (PTA).[5,6] Outcome is assessed using the Glasgow Outcome Score (GOS) or the Disability Rating Scale (DRS).[7,8] Cognitive recovery, which is assessed by more finely grained assessment tools such as neuropsychological or intelligence testing, is also used to quantify outcome from TBI. Existing clinical assessment provides some prediction of general outcome but is inadequate for predicting individual cognitive functioning.

Type
Chapter
Information
Clinical MR Neuroimaging
Physiological and Functional Techniques
 , pp. 656 - 669
Publisher: Cambridge University Press
Print publication year: 2009

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References

Kraus, JF, McArthur, DL, Silberman, TA.Epidemiology of mild brain injury. Semin Neurol 1994; 14: 1–7.CrossRefGoogle ScholarPubMed
Rice, D, MacKenzie, E. Cost of Injury in the United States. San Francisco: Institute for Health and Aging, University of California, 1989.Google Scholar
Sosin, DM, Sacks, JJ, Smith, SM. Head-injury associated deaths in the United States from 1979 to 1986. JAMA 1989; 262: 2251–2255.CrossRefGoogle ScholarPubMed
Gualtieri, CT. The problem of mild brain injury. Neuropsychiatr Neuropsychol Behav Neurol 1995; 8: 127–136.Google Scholar
Teasdale, G, Jennett, B. Assessment of coma and impaired consciousness. Lancet 1974; 2: 81–84.CrossRefGoogle ScholarPubMed
Russell, WR. Cerebral involvement in head injury. Brain 1932; 55: 549–603.CrossRefGoogle Scholar
Jennett, B, Bond, M. Assessment of outcome after severe brain damage: a practical scale. Lancet 1975; 1: 480–484.CrossRefGoogle Scholar
Clifton, GL, Hayes, RL, Levin, HS, Michel, ME, Choi, SC. Outcome measures for clinical-trials involving traumatically brain-injured patients: report of a conference. Neurosurgery 1992; 31: 975–978.CrossRefGoogle ScholarPubMed
Graham, DI, Gentleman, SM, Lynch, A, Roberts, GW. Distribution of β-amyloid protein in the brain following severe head injury. Neuropathol Appl Neurobiol 1995; 21: 27–34.CrossRefGoogle ScholarPubMed
Povlishock, JT, Christman, CW. The pathobiology of traumatically induced axonal injury in animals and humans: a review of current thoughts. J Neurotrauma 1995; 12: 555–564.CrossRefGoogle ScholarPubMed
Bigler, ED. Neuroimaging and traumatic brain injury. In Neuroimaging, Vol. II: Clinical applications, ed. Bigler, P. New York: Plenum Press, 1996, pp. 261–278.CrossRefGoogle Scholar
Levin, HS, Williams, DH, Eisenberg, HM, High, WM, Jr., Guinto, FC, Jr. Serial MRI and neurobehavioural findings after mild to moderate closed head injury. J Neurol Neurosurg Psychiatry 1992; 55: 255–262.CrossRefGoogle ScholarPubMed
Blatter, DD, Bigler, ED, et al. MR-based brain and cerebrospinal fluid measurement after traumatic brain injury: correlation with neuropsychological outcomeAJNR Am J Neuroradiol 1997; 18: 1–10.Google ScholarPubMed
Dail, WG, Feeney, DM, Murray, HM, Linn, RT, Boyeson, MG. Responses to cortical injury 2: widespread depression of the activity of an enzyme in cortex remote from a focal injury. Brain Res 1981; 211: 79–89.CrossRefGoogle Scholar
O’Neill, J, Eberling, JL, Schuff, N, et al. Method to correlate 1H MRSI and 18FDG-PET. Magn Reson Med 2000; 43: 244–250.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
Goodman, JC, Valadka, AB, Gopinath, SP, Uzura, M, Robertson, CS. Extracellular lactate and glucose alterations in the brain after head injury measured by microdialysis. Crit Care Med 1999; 27: 1965–1973.CrossRefGoogle ScholarPubMed
Holshouser, BA, Ashwal, S, Luh, GY, et al. Proton MR spectroscopy after acute nervous system injury: outcome prediction in neonates, infants, and children. Radiology 1997; 202: 487–496.CrossRefGoogle Scholar
Condon, B, Oluoch-Olunya, D, Hadley, D, Teasdale, F, Wagstaff, A. Early 1H magnetic resonance spectroscopy of acute head injury: Four cases. J Neurotrauma 1998; 15: 563–571.CrossRefGoogle ScholarPubMed
Haseler, LJ, Arcinue, E, Danielsen, ER, Bluml, S, Ross, BD. Evidence from proton magnetic-resonance spectroscopy for a metabolic cascade of neuronal damage in shaken baby syndrome. Pediatrics 1997; 99: 4–14.CrossRefGoogle ScholarPubMed
Ross, BD, Ernst, T, Kreis, R, et al. 1H MRS in acute traumatic brain injury, J Magn Reson Imaging 1998; 8: 829–840.CrossRefGoogle ScholarPubMed
Ashwal, S, Holshouser, BA, Shu, SK, et al. Predictive value of proton magnetic resonance spectorscopy in pediatric closed head injury. Pediatr Neurol 2000; 23: 114–125.CrossRefGoogle Scholar
Brenner, T, Freier, MC, Holshouser, BA, Burley, T, Ashwal, S. Predicting neuropsychological outcome after traumatic brain injury in children. Pediatr Neurol 2003; 28: 104–114.CrossRefGoogle ScholarPubMed
Makoroff, KL, Cecil, KM, Care, M, Ball, WS, Jr. Elevated lactate as an early marker of brain injury in inflicted traumatic brain injury. Pediatr Radiol 2005; 35: 668–676.CrossRefGoogle ScholarPubMed
Holshouser, BA, Ashwal, S, Shu, S, Hinshaw, DB. Proton MR spectroscopy in children with acute brain injury: comparisons of short and long echo time acquisitions. J Magn Reson Imaging 2000; 11: 9–19.3.0.CO;2-6>CrossRefGoogle Scholar
Felber, SR, Ettl, AR, Birbarner, GG, Luz, G, Aichner, FT. MR imaging and proton spectroscopy of the brain in posttraumatic cortical blindness. J Magn Reson Imaging 1993; 3: 921–924.CrossRefGoogle ScholarPubMed
Sutton, LN, Wang, Z, Duhaime, AC, et al. Tissue lactate in pediatric head trauma: a clinical study using 1H NMR spectroscopy. Pediatr Neurosurg 1995; 22: 81–87.CrossRefGoogle ScholarPubMed
Marino, S, Zei, E, Battaglini, M, et al. Acute metabolic brain changes following traumatic brain injury and their relevance to clinical severity and outcome. J Neurol Neurosurg Psychiatry 2007; 78: 501–507.CrossRefGoogle ScholarPubMed
Cecil, KM, Hills, EC, Sandel, E, et al. Proton magnetic-resonance spectroscopy for detection of axonal injury in the splenium of the corpus-callosum of brain-injured patients. J Neurosurg 1998; 88: 795–801.CrossRefGoogle ScholarPubMed
Sinson, G, Bagley, LJ, Cecil, KM, et al. Magnetization transfer imaging and proton MR spectroscopy in the evaluation of axonal injury: correlation with clinical outcome after traumatic brain injury. AJNR Am J Neuroradiol 2001; 1: 143–151.Google Scholar
Garnett, MR, Blamire, AM, Rajagopalan, B, Styles, P, Cadoux-Hudson, TAD. Evidence for cellular damage in normal-appearing white matter correlates with injury severity in patients following traumatic brain injury: a magnetic resonance study. Brain 2000; 123: 1403–1409.CrossRefGoogle Scholar
Garnett, MR, Blamire, AM, Corkill, RG, et al. Early proton magnetic resonance spectroscopy in normal-appearing brain correlates with outcome in patients following traumatic brain injury. Brain 2000; 123: 2046–2054.CrossRefGoogle ScholarPubMed
Ricci, R, Barbarella, G, Musi, P, et al. Localised proton MR spectroscopy of brain metabolism in vegetative patients. Neuroradiology 1997; 39: 313–319.CrossRefGoogle ScholarPubMed
Brooks, WM, Stidley, CA, Petropoulos, H, et al. Metabolic and cognitive response to human traumatic brain injury: a quantitative proton magnetic resonance study. J Neurotrauma 2000; 17: 629–640.CrossRefGoogle ScholarPubMed
Friedman, SD, Brooks, WM, Jung, RE, Hart, BL, Yeo, RA. Proton MR spectroscopic findings correspond to neuropsychological function in traumatic brain injury. AJNR Am J Neuroradiol 1998; 19: 1879–1885.Google ScholarPubMed
Friedman, SD, Brooks, WM, Jung, RE, et al. Quantitative 1H-MRS predicts outcome following traumatic brain injury. Neurology 1999; 52: 1384–1391.CrossRefGoogle Scholar
Yoon, SJ, Lee, JH, Kim, ST, Chun, MH. Evaluation of traumatic brain injured patients in correlation with functional status in rehabilitation medicine by localized 1H MR spectroscopy. Clin Rehab 2005; 19: 209–215.CrossRefGoogle ScholarPubMed
Zampolini, M, Tarducci, R, Gobbi, G, et al. Localized in vivo 1H-MRS of traumatic brain injury. Eur J Neurol 1997; 4: 246–254.CrossRefGoogle Scholar
Brief, E, Vernon-Wilkinson, R, MacKay, AL, et al. 1H MRS, MRI and neuropsychological testing of patients with traumatic brain injury at long elapsed time since injury. In Proceedings of the 8th Annual Meeting of the International Society of Magnetic Resonance in Medicine, Denver, 2000, p. 1138.Google Scholar
Macmillan, CSA, Wild, JM, Wardlaw, JM, et al. Traumatic brain injury and subarachnoid hemorrhage: in vivo occult pathology demonstrated by magnetic resonance spectroscopy may not be ‘‘ischaemic.’’ A primary study and review of the literature. Acta Neurochir 2002; 144: 853–862.CrossRefGoogle Scholar
Gasparovic, C, Arfai, N, Smid, N, Feeney, DM. Decrease and recovery of N-acetylaspartate/creatine in rat brain remote from focal Injury. J Neurotrauma 2000; 18: 241–246.CrossRefGoogle Scholar
Schuhmann, MU, Stiller, D, Skardelly, M, et al. Metabolic changes in the vicinity of brain contusion: a proton magnetic resonance spectroscopy and histology study. J Neurotrauma 2003; 20: 725–743.CrossRefGoogle Scholar
Nakabayashi, M, Suzaki, S, Tomita, H. Neural injury and recovery near cortical contusions: a clinical magnetic resonance spectroscopy study. J Neurosurg 2007; 106: 370–377.CrossRefGoogle ScholarPubMed
Cohen, BA, Inglese, M, Rusinek, H, et al. Proton, MRspectroscopy and MRI-volumetry in mild traumatic brain injury. AJNR Am J Neuroradiol 2007; 28: 907–913.Google ScholarPubMed
Govindaraju, V, Gauger, GE, Manley, GT, et al. Volumetric proton spectroscopic imaging of mild traumatic brain injury. AJNR Am J Neuroradiol 2004; 25: 730–737.Google ScholarPubMed
Kirov, I, Fleysher, L, Babb, JS, et al. Characterizing “mild” in traumatic brain injury with proton MR spectroscopy in the thalamus: initial findings. Brain Injury 2007; 21: 1147–1154.CrossRefGoogle ScholarPubMed
D’Adamo, AF, Jr., Yatsu, FM. Acetate metabolism in the nervous system N-acetyl-l-aspartic acid and the biosynthesis of brain lipids. J Neurochem 1966; 13: 961–965.CrossRefGoogle ScholarPubMed
Smith, DH, Cecil, KM, Meaney, DF, et al. Magnetic resonance spectroscopy of diffuse brain trauma in the pig. J Neurotrauma 1998; 15: 665–674.CrossRefGoogle ScholarPubMed
Bates, TE, Strangward, M, Keelan, J, et al. Inhibition of N-acetylaspartate production: implications for 1H-MRS studies in vivo. Neuroreport 1996; 7: 1397–1400.CrossRefGoogle ScholarPubMed
Bergsneider, M, Hovda, DA, Lee, SM, et al, Dissociation of cerebral glucose metabolism and level of consciousness during the period of metabolic depression following human traumatic brain injury. J Neurotrauma 2000; 17: 389–401.CrossRefGoogle ScholarPubMed
Bergsneider, M, Hovda, DA, McArthur, DL, et al. Metabolic recovery following human traumatic brain injury based on FDG-PET: time course and relationship to neurological disability. J Head Trauma Rehabil 2001; 16: 135–148.CrossRefGoogle ScholarPubMed
Lee, JH, Arcinue, E, Ross, BD. Brief report: organic osmolytes in the brain of an infant with hypernatremia, N Engl J Med 1994; 331: 439–442.CrossRefGoogle ScholarPubMed
Saey-Marinier, D, Calabrese, G, Hetherington, HP, et al. Proton MRS of human brain: applications to normal white matter, chronic infarction, and MRI white matter signal hyperintensities. Magn Reson Med 1992; 26: 313–327.CrossRefGoogle Scholar
Brand, A, Richter-Landsberg, C, Leibfritz, D. Multinuclear NMR studies on the energy metabolism of glial and neuronal cells. Dev Neurosci 1993; 15: 289–298.CrossRefGoogle ScholarPubMed
Lien, YH, Shapiro, JI, Chan, L. Effects of hypernatremia on organic brain osmolites. J Clin Invest 1990; 85: 427–1435.CrossRefGoogle Scholar
Barzo, P, Marmarou, A, Fatouros, P, Hayasaki, K, Corwin, F. Contribution of vasogenic and cellular edema to traumatic brain swelling measured by diffusion-weighted imaging. J Neurosurg 1997; 87: 900–907.CrossRefGoogle ScholarPubMed
Ross, BD, Bluml, S, Cowan, R, et al. In vivo MR spectroscopy of human dementia. Neuroimaging Clin N Am 1998; 8: 809–822.Google ScholarPubMed
Shutter, L, Tong, KA, Holshouser, BA. Proton MRS in acute traumatic brain injury: role for glutamate/glutamine and choline for outcome prediction. J Neurotrauma 2004; 21: 1693–1705.CrossRefGoogle ScholarPubMed
Ashwal, S, Holshouser, B, Tong, K, et al. Proton MR spectroscopy detected glutamate/glutamine is increased in children with traumatic brain injury. J Neurotrauma 2004; 21: 1539–1552.CrossRefGoogle ScholarPubMed
Uzan, M, Albayram, S, Dashti, SGR, et al. Thalamic proton magnetic resonance spectroscopy in vegetative state induced by traumatic brain injury. J Neurol Neurosurg Psychiatry 2003; 74: 33–38.CrossRefGoogle ScholarPubMed
Babikian, T, Freier, MC, Ashwal, S, et al. MR spectroscopy: predicting long-term neuropsychological outcome following pediatric TBI. J Magn Reson Imaging 2006; 24: 801–811.CrossRefGoogle ScholarPubMed
Cadoux-Hudson, TAD, Wade, D, Taylor, DJ, et al. Persistant metabolic sequelae of severe head injury in humans in vivo. Acta Neurochir (Wien) 1990; 104: 1–7.CrossRefGoogle Scholar
Garnett, MR, Corkill, RG, Cadoux-Hudson, TAD, et al. Altered metabolite profile in normal appearing brain following acute brain injury: a phosphorous MRS study. In Proceedings of the 8th Annual Meeting of the International Society for Magnetic Resonance in Medicine, Denver, 2000, p. 1139.Google Scholar
Rango, M, Lenkinski, RE, Alves, WM, Gennarelli, TA.Brain pH in head injury: an image-guided 31P magnetic resonance study. Ann Neurol 1990; 28: 661–667.CrossRefGoogle Scholar

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