From the Department of Radiology, New York University School of Medicine, NY.
Neurology. 2014 Feb 11;82(6):521-8. doi: 10.1212/WNL.0000000000000105. Epub 2014 Jan 8.
To obtain quantitative neurometabolite measurements, specifically myoinositol (mI) and glutamate plus glutamine (Glx), markers of glial and neuronal excitation, in deep gray matter structures after mild traumatic brain injury (mTBI) using proton magnetic resonance spectroscopy ((1)H-MRS) and to compare these measurements against normal healthy control subjects.
This study approved by the institutional review board is Health Insurance Portability and Accountability Act compliant. T1-weighted MRI and multi-voxel (1)H-MRS imaging were acquired at 3 tesla from 26 patients with mTBI an average of 22 days postinjury and from 13 age-matched healthy controls. Two-way analysis of variance was used to compare patients and controls for mean N-acetylaspartate, choline, creatine (Cr), Glx, and mI levels as well as the respective ratios to Cr within the caudate, globus pallidus, putamen, and thalamus.
Quantitative putaminal mI was higher in patients with mTBI compared with controls (p = 0.02). Quantitative neurometabolite ratios of putaminal mI and Glx relative to Cr, mI/Cr, and Glx/Cr were also higher among patients with mTBI compared with controls (p = 0.01 and 0.02, respectively). No other differences in neurometabolite levels or ratios were observed in any other brain region evaluated.
Increased putaminal mI, mI/Cr, and Glx/Cr in patients after mTBI compared with control subjects supports the notion of a complex glial and excitatory response to injury without concomitant neuronal loss, evidenced by preserved N-acetylaspartate levels in this region.
使用质子磁共振波谱（1H-MRS）获得轻度创伤性脑损伤（mTBI）后深部灰质结构中定量神经代谢物测量值，特别是肌醇（mI）和谷氨酸加谷氨酰胺（Glx），这些是神经胶质和神经元兴奋的标志物，并将这些测量值与正常健康对照组进行比较。
本研究经机构审查委员会批准，符合《健康保险流通与责任法案》的规定。在 3T 磁共振扫描仪上获得 T1 加权 MRI 和多体素（1）H-MRS 成像，共纳入 26 例 mTBI 患者（平均受伤后 22 天）和 13 例年龄匹配的健康对照组。使用双向方差分析比较患者和对照组之间的平均 N-乙酰天冬氨酸、胆碱、肌酸（Cr）、Glx 和 mI 水平，以及纹状体、苍白球、壳核和丘脑内 Cr 的各自比值。
与对照组相比，mTBI 患者的纹状体定量 mI 更高（p = 0.02）。与对照组相比，mTBI 患者的纹状体 mI 和 Glx 与 Cr 的比值，mI/Cr 和 Glx/Cr 也更高（分别为 p = 0.01 和 0.02）。在评估的任何其他脑区，均未观察到神经代谢物水平或比值的其他差异。
与对照组相比，mTBI 患者的纹状体 mI、mI/Cr 和 Glx/Cr 增加支持了损伤后存在复杂的神经胶质和兴奋反应的观点，而该区域的 N-乙酰天冬氨酸水平保持不变，提示没有伴随神经元丢失。
