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Magnetic resonance spectroscopy following mild traumatic brain injury: A systematic review and meta-analysis on the potential to detect posttraumatic neurodegeneration

Neurodegenerative Diseases Jul 05, 2020

Eisele A, Hill-Strathy M, Michels L, et al. - Via performing a systematic review and meta-analysis, researchers sought to ascertain the value of magnetic resonance spectroscopy (MRS) for identification of changes in brain metabolism in adult patients after a single mild traumatic brain injury (mTBI) with a negative routine brain scan (CCT and/or MRI scan) vs age- and gender-matched healthy controls (HC) during the acute or subacute postinjury phase (≤ 90 days after mTBI). A comprehensive literature search from the first edition of electronic databases until January 31, 2020 yielded 5,417 articles; of these four and two were included in the meta-analysis and systematic review, respectively. Fifty mTBI patients and 51 HCs were scanned for the meta-analysis, using N-acetyl-aspartate (NAA), a marker for neuronal integrity. Two out of the four included articles used glutamate (Glu), a marker for disturbed brain metabolism, choline (Cho), a marker for increased cell membrane turnover, and creatine (Cr). Compared with HC, patients showed decreased NAA with an effect size (ES) of –0.49 (95% CI –1.08 to 0.09), primarily measured in the frontal lobe. Per findings, changes in posttraumatic brain metabolism were detected with MRS that correlated with cognitive dysfunction and, thus, MRS might aid in identifying mTBI patients at risk for unfavorable outcome or posttraumatic neurodegeneration early.

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