Department of Radiology, University of Miami School of Medicine, Miami, Florida 33136, USA.
J Neurotrauma. 2010 Mar;27(3):483-96. doi: 10.1089/neu.2009.1159.
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.
采用容积质子磁共振波谱成像（MRSI）技术评估了轻度至中度闭合性颅脑外伤（mTBI）后磁共振（MR）可观察到的脑代谢物 N-乙酰天冬氨酸（NAA）、总胆碱（Cho）和总肌酸（Cre）分布的变化。这些研究是在损伤后的亚急性期进行的，并评估了代谢物指数与神经心理学测试（NPT）结果的相关性。共纳入 29 例 mTBI 患者，格拉斯哥昏迷量表（GCS）评分为 10-15。评估了个体代谢物和代谢物比相对于年龄匹配的对照组的分布差异，以及对侧半球和组织类型的分析。主要发现包括在 TBI 患者组的所有脑叶中，NAA 和 NAA/Cre 广泛减少，Cho 和 Cho/NAA 增加，在白质中差异最大。检查所有代谢物测量值与 NPT 评分之间的相关性发现，在额叶中，Cho/NAA 与 NPT 评分呈最强的负相关。在任何 MRSI 或 NPT 测量值与 GCS 之间均未发现显著相关性。这些结果表明，轻度至中度 TBI 会导致脑代谢物发生显著且广泛的改变，这些测量值与认知表现的测量值相关。
