Document Detail


Impact of methamphetamine on regional metabolism and cerebral blood flow after traumatic brain injury.
MedLine Citation:
PMID:  23836426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Substance abuse is a frequent comorbid condition among patients with traumatic brain injury (TBI), but little is known about its potential additive or interactive effects on tissue injury or recovery from TBI. This study aims to evaluate changes in regional metabolism and cerebral perfusion in subjects who used methamphetamine (METH) prior to sustaining a TBI. We hypothesized that METH use would decrease pericontusional cerebral perfusion and markers of neuronal metabolism, in TBI patients compared to those without METH use.
METHODS: This is a single center prospective observational study. Adults with moderate and severe TBI were included. MRI scanning was performed on a 3 Tesla scanner. MP-RAGE and FLAIR sequences as well as Metabolite spectra of NAA and lactate in pericontusional and contralateral voxels identified on the MP-RAGE scans. A spiral-based FAIR sequence was used for the acquisition of cerebral blood flow (CBF) maps. Regional CBF images were analyzed using ImageJ open source software. Pericontusional and contralateral CBF, NAA, and lactate were assessed in the entire cohort and in the METH and non-METH groups.
RESULTS: Seventeen subjects completed the MR studies. Analysis of entire cohort: pericontusional NAA concentrations (5.81 ± 2.0 mM/kg) were 12% lower compared to the contralateral NAA (6.98 ± 1.2 mM/kg; p = 0.03). Lactate concentrations and CBF were not significantly different between the two regions; however, regional CBF was equally reduced in the two regions. Subgroup analysis: 41% of subjects tested positive for METH. The mean age, Glasgow Coma Scale, and time to scan did not differ between groups. The two subject groups also had similar regional NAA and lactate. Pericontusional CBF was 60% lower in the METH users than the non-users, p = 0.04; contralateral CBF did not differ between the groups.
CONCLUSION: This small study demonstrates that tissue metabolism is regionally heterogeneous after TBI and pericontusional perfusion was significantly reduced in the METH subgroup.
Authors:
Kristine O'Phelan; Thomas Ernst; Dalnam Park; Andrew Stenger; Katherine Denny; Deborah Green; Cherylee Chang; Linda Chang
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Publication Detail:
Type:  Journal Article; Observational Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Neurocritical care     Volume:  19     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-23     Completed Date:  2014-05-12     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-91     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amphetamine-Related Disorders / complications,  metabolism*
Aspartic Acid / analogs & derivatives,  metabolism
Brain / blood supply,  drug effects,  metabolism
Brain Injuries / complications,  metabolism*
Central Nervous System Stimulants / adverse effects*
Cerebrovascular Circulation / drug effects*,  physiology
Female
Humans
Lactic Acid / metabolism
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Male
Methamphetamine / adverse effects*
Middle Aged
Perfusion Imaging
Prospective Studies
Young Adult
Grant Support
ID/Acronym/Agency:
K02 DA020569/DA/NIDA NIH HHS; R03DA24199/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Central Nervous System Stimulants; 30KYC7MIAI/Aspartic Acid; 33X04XA5AT/Lactic Acid; 44RAL3456C/Methamphetamine; 997-55-7/N-acetylaspartate
Comments/Corrections

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