| Assessment of mitochondrial impairment in traumatic brain injury using high-resolution proton magnetic resonance spectroscopy. | |
| | |
MedLine Citation:
|
PMID: 18173309 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: The goal of this study was to demonstrate the posttraumatic neurochemical damage in normal-appearing brain and to assess mitochondrial dysfunction by measuring N-acetylaspartate (NAA) levels in patients with severe head injuries, using proton (1H) magnetic resonance (MR) spectroscopy. METHODS: Semiquantitative analysis of NAA relative to creatine-containing compounds (Cr) and choline (Cho) was carried out from proton spectra obtained by means of chemical shift (CS) imaging and single-voxel (SV) methods in 25 patients with severe traumatic brain injuries (TBIs) (Glasgow Coma Scale scores < or = 8) using a 1.5-tesla MR unit. Proton MR spectroscopy was also performed in 5 healthy volunteers (controls). RESULTS: The SV studies in patients with diffuse TBI showed partial reduction of NAA/Cho and NAA/Cr ratios within the first 10 days after injury (means +/- standard deviations 1.59 +/- 0.46 and 1.44 +/- 0.21, respectively, in the patients compared with 2.08 +/- 0.26 and 2.04 +/- 0.31, respectively, in the controls; nonsignificant difference). The ratios gradually declined in all patients as time from injury increased (mean minimum values NAA/Cho 1.05 +/- 0.44 and NAA/Cr 1.05 +/- 0.30, p < 0.03 and p < 0.02, respectively). This reduction was greater in patients with less favorable outcomes. In patients with focal injuries, the periphery of the lesions revealed identical trends of NAA/Cho and NAA/Cr decrease. These reductions correlated with outcome at 6 months (p < 0.01). Assessment with multivoxel methods (CS imaging) demonstrated that, in diffuse injury, NAA levels declined uniformly throughout the brain. At 40 days postinjury, initially low NAA/Cho levels had recovered to near baseline in patients who had good outcomes, whereas no recovery was evident in patients with poor outcomes (p < 0.01). CONCLUSIONS: Using (1)H-MR spectroscopy, it is possible to detect the posttraumatic neurochemical damage of the injured brain when conventional neuroimaging techniques reveal no abnormality. Reduction of NAA levels is a dynamic process, evolving over time, decreasing and remaining low throughout the involved tissue in patients with poor outcomes. Recovery of NAA levels in patients with favorable outcomes suggests marginal mitochondrial impairment and possible resynthesis from vital neurons. |
| | |
Authors:
|
Stefano Signoretti; Anthony Marmarou; Gunes A Aygok; Panos P Fatouros; Gina Portella; Ross M Bullock |
Related Documents
:
|
12655389 - Outcomes of patients referred for confirmation of brain death by 99mtc-exametazime scin... 18431379 - 'noisy patients'--can signal detection theory help? 9151329 - Brain perfusion spect abnormalities in neuronal ceroid lipofuscinoses. 1239979 - Post-lesion yawning and thalamotomy site. 10635379 - Brain viability and function analyzer: multiparametric real-time monitoring in neurosur... 15517279 - Real time fmri: a tool for the routine presurgical localisation of the motor cortex. 3470229 - Levels of ca 125 in patients with recurrent carcinoma of the fallopian tube: two case h... 20079919 - Evaluation of modified non-overt dic criteria on the prediction of poor outcome in pati... 12655389 - Outcomes of patients referred for confirmation of brain death by 99mtc-exametazime scin... |
Publication Detail:
|
Type: Controlled Clinical Trial; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: Journal of neurosurgery Volume: 108 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2008 Jan |
Date Detail:
|
Created Date: 2008-01-04 Completed Date: 2008-02-05 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
|
Languages: eng Pagination: 42-52 Citation Subset: AIM; IM |
Affiliation:
|
Department of Neurosurgery, Virginia Commonwealth University Medical Center, Richmond, Virginia, 23298-0508, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aspartic Acid / analogs & derivatives, metabolism Brain Injuries / complications*, metabolism Choline / metabolism Creatine / metabolism Female Follow-Up Studies Humans Magnetic Resonance Spectroscopy* Male Middle Aged Mitochondrial Diseases / diagnosis*, etiology* Outcome Assessment (Health Care) Predictive Value of Tests Time Factors |
| Grant Support | |
ID/Acronym/Agency:
|
NS12587/NS/NINDS NIH HHS; NS19235/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
|
56-84-8/Aspartic Acid; 57-00-1/Creatine; 62-49-7/Choline; 997-55-7/N-acetylaspartate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Preoperative depiction of cavernous sinus invasion by pituitary macroadenoma using three-dimensional...
Next Document: Brain tissue oxygen tension response to induced hyperoxia reduced in hypoperfused brain.