Whole Brain Magnetic Resonance Spectroscopic Determinants of Functional Outcomes in Pediatric Moderate/Severe Traumatic Brain Injury

Diffuse axonal injury contributes to the long-term functional morbidity observed following pediatric moderate/severe traumatic brain injury (msTBI). Whole-Brain Proton Magnetic Resonance Echo-Planar Spectroscopic Imaging was used to measure the neurometabolite levels in the brain to delineate the course of disruption/repair during the first year post msTBI. The association between metabolite biomarkers and functional measures (cognitive functioning and CC function assessed by interhemispheric transfer time (IHTT) using an Event Related Potential paradigm) was also explored. Pediatric msTBI patients underwent assessments at two times (post-acutely at a mean of 3 months post-injury, n = 31 and chronically at a mean of 16 months post injury, n = 24). Healthy controls also underwent two evaluations, approximately 12 months apart. Post-acutely, in patients with msTBI there were elevations in choline (Cho; marker for inflammation and/or altered membrane metabolism) in all four brain lobes and the CC and decreas...