The primary aim of this prospective study was to test the hypothesis that early 3D MR spectroscopic (MRSI) changes in discrete regions of the brain after TBI predict neuropsychologic outcomes 1 year after injury. MRSI was acquired at 3T in 68 pediatric mild to severe TBI subjects and 72 controls. Subacute NAA/Cr and NAA/Cho ratios were significantly reduced in TBI patients in all brain regions. A binary logistic regression analysis using combined subcortical NAA/Cr ratios alone predicted dichotomized neurologic outcome (93%), Full Scale IQ (78%), General Memory (82%) and General Attention (88%).
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