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Longitudinal MR Spectroscopy Shows Altered Metabolism in Traumatic Brain Injury
Author(s) -
Maudsley Andrew A.,
Govind Varan,
Saigal Gaurav,
Gold Stuart G.,
Harris Leo,
Sheriff Sulaiman
Publication year - 2017
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12463
Subject(s) - traumatic brain injury , medicine , creatine , white matter , glasgow coma scale , choline , magnetic resonance imaging , magnetic resonance spectroscopic imaging , nuclear medicine , pathology , radiology , surgery , psychiatry
BACKGROUND AND PURPOSE Brain trauma is known to result in heterogeneous patterns of tissue damage and altered neuronal and glial metabolism that evolve over time following injury; however, little is known on the longitudinal evolution of these changes. In this study, magnetic resonance spectroscopic imaging (MRSI) was used to map the distributions of altered metabolism in a single subject at five time points over a period of 28 months following injury. METHODS Magnetic resonance imaging and volumetric MRSI data were acquired in a subject that had experienced a moderate traumatic brain injury (Glasgow Coma Scale 13) at five time points, from 7 weeks to 28 months after injury. Maps of N‐acetylaspartate (NAA), total choline (Cho), and total creatine signal were generated and differences from normal control values identified using a z ‐score image analysis method. RESULTS The z ‐score metabolite maps revealed areas of significantly reduced NAA and increased Cho, predominately located in frontal and parietal white matter, which evolved over the complete course of the study. A map of the ratio of Cho/NAA showed the greatest sensitivity to change, which indicated additional metabolic changes throughout white matter. The metabolic changes reduced over time following injury, though with abnormal values remaining in periventricular regions. CONCLUSIONS The use of z ‐score image analysis for MRSI provides a method for visualizing diffuse changes of tissue metabolism in the brain. This image visualization method is of particularly effective for visualizing widespread and diffuse metabolic changes, such as that due to traumatic injury.