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Table 2 Outcome of traumatic brain injury by magnetic resonance spectroscopy

From: Clinical review: Prognostic value of magnetic resonance imaging in acute brain injury and coma

  Authors (ref.)
  Choe, 1995 [43] Ricci, 1997 [39] Ross, 1998 [40] Friedman, 1999 [36] Garnett, 2000 [37] Sinson, 2001 [41] Uzan, 2003 [42] Carpentier, 2006 [17] Marino, 2006 [38]
Study design Case-control Prospective Prospective Case-control Prospective Prospective Case-control Prospective Case-control
Delay 2 weeks to 11 months 1 to 90 months 1 to 74 days 45 ± 21 days/6 months 12 days (3–35)/6.2 months (2.9–50.6) 41 days (median) 6 to 8 months 17.5 ± 6.4 days 48 to 72 hours
Number of patients 10 TBI patients versus 10 control individuals 14 VS TBI patients 25 TBI patients (12 children) 14 TBI patients versus 14 control individuals 26 patients. Early study: 21. Late study: 15. Both: 10 30 TBI patients 14 VS TBI patients versus 5 control individuals 40 TBI patients 10 TBI patients versus 10 control individuals
Grey matter voxel location NA NA Occipitoparietal Occipitoparietal Frontal NA Thalamus NA Mesial cortex
White matter voxel location Frontoparietal Frontal Occipitoparietal Occipitoparietal Frontal Splenium of corpus callosum NA Pons Corpus callosum, mostly white matter
Outcome variable of interest GOS score after MRI GOS score (1–2 versus 3–5) at follow upa ROS at discharge and follow upb GOS score and neuropsychological performance GOS score, DRS at 6 months GOS score at 3 months (1–4 versus 5) Aware versus not aware at >6 months GOS score (1–2 versus 4–5), DRS at 18 months GOS score at 3 months
Main results NAA/Cr ratio lower in TBI patients. NAA/Cr ratio correlated with GOS score NAA/Cr ratio and NAA/Cho ratio lower, Cho/Cr ratio elevated, and NAA/Cho lower in GOS score 1–2 versus GOS 3–5 NAA levels diminished. NAA/Cr ratio correlated with outcome NAA levels in white matter lower in TBI patients. Early NAA levels in grey matter correlated with GOS NAA/Cr ratio lower in TBI patients. Cho/Cr elevated in TBI patients. NAA/Cr ratio correlated with GOS score and DRS NAA/Cr ratio lower. NAA/Cr correlated with GOS score NAA/Cr ratio lower in VS. NAA/Cr ratio lower in patients remained in VS compared with patients who regained awareness NAA/Cr ratio correlated to GOS score and DRS. No correlation between NAA/Cr ratio and lesions burden on FLAIR or T2* NAA/Cr and NAA/all metabolites ratios lower. La/Cr and La/all metabolites ratios increased in TBI
  1. aNo further information. bUp to 2 years, except for four out of 25 patients. Cho, choline; Cr, creatinine; DRS, disability rating scale; FLAIR, fluid-attenuated inversion recovery; GOS, Glasgow Outcome Scale; La, lactate; MRI, magnetic resonance imaging; NA, not applicable; NAA, N-acetyl-aspartate; ROS, Rancho Los Amigos Medical Centre Outcome Score; T2*, T2* weighted sequence; TBI, traumatic brain injury; VS, vegetative state.