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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.