NEURONAL DYSFUNCTION IN PATIENTS WITH CLOSED-HEAD INJURY EVALUATED BYIN-VIVO H-1 MAGNETIC-RESONANCE SPECTROSCOPY

RATIONALE AND OBJECTIVES. With the use of localized, water-suppressed in vivo H-1 magnetic resonance spectroscopy (MRS), the proton metaboli c alterations of white matter in patients with closed head injury (CHI ) and healthy controls are evaluated, and metabolic alterations with G lasgow Outcome Scale (GOS) scores are compared, METHODS. Patients with CHI (n = 10) and healthy control subjects (n = 10) underwent MRS exam inations using a stimulated-echo acquisition mode pulse sequence that provided 2 X 2 X 2 cm(3) volume of interest in the left frontoparietal white matter, Proton metabolite ratios relative to creatine were obta ined using a Marquart algorithm, RESULTS. The specific feature in pati ents with CHI was significant decrease of N-acetylaspartate (NAA)/crea tine ratio compared with normal controls, No clear correlation of othe r metabolite ratios such as choline/creatine and inositols creatine wa s established, The level of NAA/creatine ratio was significantly corre lated with GOS, CONCLUSIONS. Results of this preliminary study suggest that the reduction of NAA/creatine ratio may indicate neuronal loss i n patients with CHI. The NAA/creatine ratio may serve as a metabolic c riterion to predict the GOS of patients with CHI, Thus, in vivo H-1 MR S may be a useful modality in the clinical evaluation of patients with CHI based on the proton metabolite concentrations of cerebral white m atter.