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Metabolic levels in the corpus callosum and their structural and behavioral correlates after moderate to severe pediatric TBI.

Abstract：

:Diffuse axonal injury (DAI) secondary to traumatic brain injury (TBI) contributes to long-term functional morbidity. The corpus callosum (CC) is particularly vulnerable to this type of injury. Magnetic resonance spectroscopy (MRS) was used to characterize the metabolic status of two CC regions of interest (ROIs) (anterior and posterior), and their structural (diffusion tensor imaging; DTI) and neurobehavioral (neurocognitive functioning, bimanual coordination, and interhemispheric transfer time [IHTT]) correlates. Two groups of moderate/severe TBI patients (ages 12-18 years) were studied: post-acute (5 months post-injury; n = 10), and chronic (14.7 months post-injury; n = 8), in addition to 10 age-matched healthy controls. Creatine (energy metabolism) did not differ between groups across both ROIs and time points. In the TBI group, choline (membrane degeneration/inflammation) was elevated for both ROIs at the post-acute but not chronic period. N-acetyl aspartate (NAA) (neuronal/axonal integrity) was reduced initially for both ROIs, with partial normalization at the chronic time point. Posterior, not anterior, NAA was positively correlated with DTI fractional anisotropy (FA) (r = 0.88), and most domains of neurocognition (r range 0.22-0.65), and negatively correlated with IHTT (r = -0.89). Inverse corerlations were noted between creatine and posterior FA (r = -0.76), neurocognition (r range -0.22 to -0.71), and IHTT (r = 0.76). Multimodal studies at distinct time points in specific brain structures are necessary to delineate the course of the degenerative and reparative processes following TBI, which allows for preliminary hypotheses about the nature and course of the neural mechanisms of subsequent functional morbidity. This will help guide the future development of targeted therapeutic agents.

journal_name

J Neurotrauma

journal_title

Journal of neurotrauma

authors

Babikian T,Marion SD,Copeland S,Alger JR,O'Neill J,Cazalis F,Mink R,Giza CC,Vu JA,Hilleary SM,Kernan CL,Newman N,Asarnow RF

doi

10.1089/neu.2009.1058

subject

Has Abstract

pub_date

2010-03-01 00:00:00

pages

473-81

issue

eissn

0897-7151

issn

1557-9042

journal_volume

pub_type

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Metabolic levels in the corpus callosum and their structural and behavioral correlates after moderate to severe pediatric TBI.