Phosphorus spectroscopy in acute TBI demonstrates metabolic changes that relate to outcome in the presence of normal structural MRI.

TitlePhosphorus spectroscopy in acute TBI demonstrates metabolic changes that relate to outcome in the presence of normal structural MRI.
Publication TypeJournal Article
Year of Publication2018
AuthorsStovell, MG, Mada, MO, T Carpenter, A, Yan, J-L, Guilfoyle, MR, Jalloh, I, Welsh, KE, Helmy, A, Howe, DJ, Grice, P, Mason, A, Giorgi-Coll, S, Gallagher, CN, Murphy, MP, Menon, DK, Hutchinson, PJ, Carpenter, KLh
JournalJ Cereb Blood Flow Metab
Pagination271678X18799176
Date Published2018 Sep 18
ISSN1559-7016
Abstract

Metabolic dysfunction is a key pathophysiological process in the acute phase of traumatic brain injury (TBI). Although changes in brain glucose metabolism and extracellular lactate/pyruvate ratio are well known, it was hitherto unknown whether these translate to downstream changes in ATP metabolism and intracellular pH. We have performed the first clinical voxel-based in vivo phosphorus magnetic resonance spectroscopy (P MRS) in 13 acute-phase major TBI patients versus 10 healthy controls (HCs), at 3T, focusing on eight central 2.5 × 2.5 × 2.5 cm voxels per subject. PCr/γATP ratio (a measure of energy status) in TBI patients was significantly higher (median = 1.09) than that of HCs (median = 0.93) (p  5% radiologically visible injury. This is the first clinical demonstration of brain alkalosis and elevated PCr/γATP ratio acutely after major TBI. P MRS has potential for non-invasively assessing brain injury in the absence of structural injury, predicting outcome and monitoring therapy response.

DOI10.1177/0271678X18799176
Alternate JournalJ. Cereb. Blood Flow Metab.
Citation Key10.1177/0271678X18799176
PubMed ID30226401
Grant ListG0600986 / / Medical Research Council / United Kingdom
G1002277 / / Medical Research Council / United Kingdom
NIHR-RP-R3-12-013 / / Department of Health / United Kingdom