Abstract:

Objective To determine the neurological metabolic abnormalities in different regions by ¹H-proton magnetic resonance spectroscopy (¹H-MRS) and explore their relationship with the prognosis in patients with diffuse axonal injury. Methods Forty patients with diffuse axonal injury underwent ¹H-MRS examination in the sensitive zones to diffuse axonal injury such as corpus callosum, brainstem, cerebellum and nasal ganglia 1 week, 2 weeks, 3 weeks and 4 weeks after injury, and the neurometabolite alterations were evaluated and compared with those of 15 healthy volunteers (control group). Linear regression analysis was used to assess the correlation between ¹H-MRS value and Glasgow outcome scale (GOS) 6 months after injury. Results There was a significant decrease in NAA/Cr and NAA/Cho and increase in Cho/Cr in the sensitive zones in patients with diffuse axonal injury as compared with control group (P<0.05), and these trends tended to be more evident with the increase of injury severity. The neurometabolite alterations varied at different time points and regions. The correlation between neurometabolite alterations and outcome was also different at different time points and regions, and the correlation between neurometabolite alterations and outcome was the strongest in the corpus callosum and brainstem 3 weeks after injury. Conclusion ¹H-MRS examination plays a role in the evaluation of disease condition and prediction of outcomes in patients with diffuse axonal injury.

Key words: diffuse axonal injury, ¹H-proton magnetic resonance spectroscopy, neurometabolites, Glasgow outcome scale