Table 2.
Outcome of traumatic brain injury by magnetic resonance spectroscopy
| 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 |
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.