Limbic Metabolic Abnormalities in Remote Traumatic Brain Injury and Correlation With Psychiatric Morbidity and Social Functioning

Abstract

The aim of this study was to investigate limbic metabolic abnormalities in remote traumatic brain injury (TBI) and their psychiatric correlates. Twenty patients and 13 age-matched comparison subjects received complete psychiatric evaluation and brain MRI and MR spectroscopy at 3 Tesla. Patients had reduced NAA to creatine ratio in the left hippocampus relative to comparison subjects (mean=1.3 [SD=0.21] compared with mean=1.55 [SD=0.21]; F=10.73, df=1, 30, p=0.003), which correlated with the Social Functioning Examination scores (rs=−0.502, p=0.034). Furthermore, patients with mood disorders had reduced NAA to creatine ratio in the left cingulate relative to patients without mood disorders (1.47 compared with 1.68; F=3.393, df=3, 19, p=0.044). Remote TBI displays limbic metabolic abnormalities, which correlate to social outcome and psychiatric status.

Depression in children and adolescents in the first 6 months after traumatic brain injury

“…Assessment of the relative importance of demographic (age at injury), psychiatric (family history of anxiety disorder, Personality Change due to TBI), and lesion correlates (left IFG, left temporal pole, right frontal white matter lesions, left parietal lesions) were instructive. In adults with TBI, abnormal magnetic resonance spectroscopy findings in left temporal and cingulate areas are related to mood disorder (Capizzano et al, 2010). It is likely that disturbance of critical limbic areas and their relationship to emotional control underlie important neuropathological determinants in the development of post‐TBI depression (Maller et al, 2010), especially given the commonness of frontotemperolimbic damage in pediatric TBI (Bigler et al, 2010).…”

Traumatic brain injury and reserve

“…Likewise, preinjury resiliencies in such neural systems may have protective influences. Based on a model like this, Capizzano et al (2010) speculate on how pre-and post-TBI factors relate to psychiatric morbidity following injury.…”

Altered metabolites of the rat hippocampus after mild and moderate traumatic brain injury – a combined in vivo and in vitro1H–MRS study

“…Metabolites detected through 1 H-MRS provide the necessary information relating to brain injury, inflammation, hypoxia/ischemia and bioenergetic dysfunction. 9 The available literature indicates that extensive study has been performed on hippocampal metabolic irregularities using in vivo 1 H-MRS after moTBI in humans 10 and rodents; 11 however, there is a scarcity of reports on miTBI. Although studies on human miTBI have shown metabolic irregularities in lateral ventricle, splenium 12 and frontal lobe, 13 there has been no in vivo hippocampal MRS study on experimental miTBI.…”