Proton Magnetic Resonance Spectroscopy of Acute TBI

Project: Research project

Project Details


DESCRIPTION (provided by applicant): Each year 230,000 people are hospitalized
and survive moderate and severe traumatic brain injury (TBI). As a result, a
large number of individuals with TBI endure life-long impairment and
disability. Acute rating scales such as the Glasgow Coma Scale (GCS) have
shown limited predictive validity regarding patient outcome and traditional
neuroimaging techniques such as CT and MRI maintain limited correlations with
brain injury severity and cognitive functioning. Continued advances in neuroimaging,
however, have provided researchers with an important opportunity to study the pathophysiology of brain dysfunction following TBI. According to the NCMRR, "the
neurobiology of TBI in humans should be studied with modern imaging techniques". The purpose of this study is to correlate proton magnetic resonance spectroscopy (MRS), an
advanced neuroimaging technique, with behavioral measures of TBI severity and
cognitive outcome. MRS measures the concentration of cerebral metabolites
such as N-acetylaspartate (NAA), choline (Cho), and glutamate (Glu). While MRS
has shown promise in predicting brain injury severity and patient outcome, the
exact protocols for using MRS with TBI remain undetermined and the purpose of
the proposed study is to examine three critical areas: (1) the post-injury
time period when the MRS data should be acquired (e.g., within one week or
within one month of injury); (2) how metabolites should be measured (i.e.,
absolute concentrations or changes in concentration over time); and (3) the
brain locations best suited for MRS data acquisition (i.e., acquisition near
lesion sites or acquisition at sites remote from probable brain lesion). The
proposed study will make determinations in these three areas through the use
of two acute MRS scans following TBI to measure concentrations of NAA, Cho and
Glu and their correlation with injury severity and cognitive variables. In
addition, correlation of acute MRS data with behavioral data (e.g., duration
of loss of consciousness, duration of post-traumatic amnesia) will elucidate
the relationship between changes in brain metabolism and changes in patient
behavior during acute recovery from TBI. The present proposal will employ a
promising, noninvasive neuroimaging technique, MRS, to determine the most
appropriate protocols (i.e., timing, metabolic measurement, brain location for
data acquisition) for application of MRS to acute TBI. With an established
protocol for using MRS, this instrument should prove useful for determining
the effectiveness of acute interventions (e.g. hypothermia, pharmacologic
intervention) and for predicting the acute course of patient recovery.
Effective start/end date7/1/026/30/03


  • Eunice Kennedy Shriver National Institute of Child Health and Human Development: $76,500.00

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