The Post-traumatic Syndrome Of Blunt Head Injury: Noninvasive Neurochemical And Structural Assessment

[allan]

The Post-Traumatic Syndrome of Blunt Head Injury: Noninvasive Neurochemical and Structural Assessment

Blunt trauma of the human brain, occurring in the course of military operations of a wide variety, presents serious problems in assessment, treatment, and outcome prediction. Mild traumatic brain injury (TBI) is frequently followed by a clinical syndrome which is associated with serious disability, despite the absence of significant abnormalities on conventional radiologic imaging. Magnetic resonance spectroscopy has revealed changes in cerebral metabolite ratios in several sites, suggesting diffuse tissue damage. In a previous study using volumetric proton magnetic spectroscopic imaging (MRSI) at 1.5T, we have found significant changes in some brain regions for average values from all TBI subjects, with reduced N-Acetylaspartate (NAA)/Creatine (Cr), increased Choline (Cho)/Cr, and reduced NAA/Cho ratios. The results show evidence of widespread metabolic changes in regions that appear normal on diagnostic MR images. In order to clarify the extent and significance of such changes, we propose the study of a larger number of subjects, using a 4.0T system, with repeat testing at six months after injury. Moreover, the application of diffusion tensor imaging (DTI) to the study of white matter fiber systems in the brain permits an assessment of the relationship of metabolic changes in nuclear centers to the microstructural character of their connecting tracts. Data from both MRSI and DTI will be correlated with the results of neurocognitive and psychological testing. This correlation is anticipated to lead to improved understanding of the post-concussion syndrome, with early application to important decisions in the assessment and treatment of injured military personnel.

PI: Grant E. Gauger, M.D.

Funding Source: U.S. Department of Defense

Reviewed/Updated: 7/17/2006 6:06:00 PM

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Source: http://www.sf.med.va.gov/general.asp?durki...&return=704