Article Figures & Data
Figures
- Fig 1.
Position of the spectroscopic imaging VOI, as viewed in the axial and sagittal planes. On the axial image, the outlined sections inside the VOI depict voxels typically selected for the four regions of interest, and the pattern surrounding the VOI is the area covered by the eight multiple regional saturation technique (MREST) pulses for saturating lipid signals from the scalp.
- Fig 2.
Average spectra obtained from the left frontal lobe of a patient versus that of a control demonstrates a decrease in NAA after TBI.
Tables
Patient/Sex GCS Score Mechanism of Injury Age at Injury (y) Age at MRS (y) Age at Testing (y)* GOS Score MR Imaging Finding 1/M 15 Fall 7.4 7.8 7.8 1 Normal 2/F 8 Hit by auto 8.0 8.3 8.3 2 Bilateral superior frontal gyrus gray matter hemosiderin deposit 3/F 3 Hit by auto 12.1 12.4 12.3 2 R temporal lobe white matter atrophy 4/F 11 Hit by auto 8.2 9.9 10.2 1 L frontal lobe gray matter and white matter encephalomalacia and shearing injury; bilateral middle frontal, inferior frontal, and gyrus rectus encephalomalacia; L orbital gyrus encephalomalacia 5/F 4 Hit by auto 10.1 10.2 10.4 2 Bilateral frontal lobe white matter gliosis and L frontal lobe gray matter hemosiderin; L gyrus rectus gliosis; posterior corpus callosum gliosis 6/M 3 Hit by auto 10.5 11.8 11.5 1 R frontal lobe white matter gliosis and hemosiderin 7/F 10 Hit by auto 11.1 14.2 14.5 1 Bilateral gyrus rectus atrophy Note.—GCS indicates Glasgow Coma Scale; GOS, Glasgow Outcome Scale score (1 = good, 2 = moderate, 3 = severe); and MRS, MR spectroscopy.
* Age at testing is reported for the evaluation closest in time to imaging.
Group and Area NAA Cho Cr NAA/Cr NAA/Cho Left Right Left Right Left Right Left Right Left Right Patients with TBI (n = 7) Frontal 9.64 ± 0.54 9.21 ± 0.74 2.26 ± 0.29 1.88 ± 0.34 9.94 ± 1.25 9.46 ± 1.47 0.98 ± 0.12 1.00 ± 0.19 4.33 ± 0.72 5.01 ± 0.80 Parietal 9.83 ± 1.04 9.35 ± 1.57 2.10 ± 0.31 1.93 ± 0.41 9.86 ± 1.70 8.92 ± 1.35 1.02 ± 0.16 1.05 ± 0.16 4.73 ± 0.42 4.98 ± 1.12 Control subjects (n = 5) Frontal 10.46 ± 0.64 10.17 ± 0.54 2.05 ± 0.16 1.89 ± 0.36 10.26 ± 0.89 9.18 ± 0.96 1.02 ± 0.07 1.12 ± 0.13 5.13 ± 0.57 5.55 ± 1.22 Parietal 10.34 ± 0.42 9.63 ± 0.30 2.07 ± 0.52 1.76 ± 0.22 9.51 ± 1.33 8.65 ± 1.44 1.10 ± 0.13 1.14 ± 0.21 5.29 ± 1.47 5.52 ± 0.64 - TABLE 3:
Summary of the analysis of metabolites for effects of group (G), side (S), and region (R) of brain
Factor NAA Ch Cr NAA/Cr NAA/Cho F df P Value F df P Value F df P Value F df P Value F df P Value Group 3.94 1,10 0.075 1.21 1,10 .296 0.06 1,10 .816 0.47 1,10 .509 5.51 1,10 .041 Side 7.11 1,10 0.0236 8.650 1,10 .015 7.01 1,10 .024 1.17 1,10 .305 2.36 1,10 .155 Region 0.21 1,10 0.660 0.45 1,10 .520 2.23 1,10 .901 0.13 1,10 .729 0.23 1,10 .644 G × S 0.02 1,10 0.894 0.06 1,10 .809 0.17 1,10 .69 0.81 1,10 .389 0.07 1,10 .798 G × R 1.92 1,9 0.196 0.00 1,9 .956 0.28 1,9 .611 0.06 1,10 .808 0.060 1,10 .808 Test and Group Result t P Value WASI 4.26 .0017 Control 113.80 ± 12.56 TBI 85.86 ± 10.19 WJ Math 5.54 .0002 Control 120.20 ± 14.99 TBI 84.86 ± 6.91 CELF 3.87 .0031 Control 117.00 ± 9.75 TBI 92.00 ± 11.82 Note.—CELF indicates Clinical Examination of Language Function; WASI, Wechsler Abbreviated Scale of Intelligence; and WJ Math, Woodcock Johnson Arithmetic Achievement subtest.
- TABLE 5:
Pearson correlation coefficients between brain metabolite levels and cognitive scores
Test Composite L Frontal R Frontal Cho Cr NAA Cho Cr NAA Cho Cr NAA WASI Correlation −0.20 −0.02 0.29 −0.39 0.19 0.51 0.04 −0.20 0.47 P value .55 .94 .36 .21 .54 .09 .91 .54 .12 WJ MATH Correlation −0.22 0.06 0.54 −0.57 0.02 0.64 0.12 −0.07 0.72 P value .49 .84 .07 .06 .95 .03* .71 .84 .01† CELF Correlation −0.03 −0.50 0.21 −0.01 −0.11 0.32 −0.09 −0.47 0.38 P value .92 .10 .50 .99 .74 .31 .78 .12 .23 Note.—CELF indicates Clinical Examination of Language Function; WASI, Wechsler Abbreviated Scale of Intelligence; and WJ Math, Woodcock Johnson Arithmetic Achievement subtest. Correlations for L and R parietal regions were not significant and are not shown.
* P < .05.
† P < .01.
