Brain metabolites measured with magnetic resonance spectroscopy in pediatric concussion and orthopedic injury: An Advancing Concussion Assessment in Pediatrics (A‐CAP) study

Author:

La Parker L.123ORCID,Joyce Julie M.123ORCID,Bell Tiffany K.123ORCID,Mauthner Micaela123,Craig William4ORCID,Doan Quynh5ORCID,Beauchamp Miriam H.6ORCID,Zemek Roger78ORCID,Yeates Keith Owen23ORCID,Harris Ashley D.123ORCID

Affiliation:

1. Department of Radiology University of Calgary Calgary Alberta Canada

2. Alberta Children's Hospital Research Institute University of Calgary Calgary Alberta Canada

3. Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada

4. Department of Pediatrics University of Alberta and Stollery Children's Hospital Edmonton Alberta Canada

5. Department of Pediatrics University of British Columbia and BC Children's Hospital Research Institute Vancouver British Columbia Canada

6. Department of Psychology University of Montreal and Ste Justine Hospital Research Center Montreal Quebec Canada

7. Department of Pediatrics and Emergency Medicine Children's Hospital of Eastern Ontario, University of Ottawa Ottawa Ontario Canada

8. Childrens' Hospital of Eastern Ontario Research Institute University of Ottawa Ottawa Ontario Canada

Abstract

AbstractMillions of children sustain a concussion annually. Concussion disrupts cellular signaling and neural pathways within the brain but the resulting metabolic disruptions are not well characterized. Magnetic resonance spectroscopy (MRS) can examine key brain metabolites (e.g., N‐acetyl Aspartate (tNAA), glutamate (Glx), creatine (tCr), choline (tCho), and myo‐Inositol (mI)) to better understand these disruptions. In this study, we used MRS to examine differences in brain metabolites between children and adolescents with concussion versus orthopedic injury. Children and adolescents with concussion (n = 361) or orthopedic injury (OI) (n = 184) aged 8 to 17 years were recruited from five emergency departments across Canada. MRS data were collected from the left dorsolateral prefrontal cortex (L‐DLPFC) using point resolved spectroscopy (PRESS) at 3 T at a mean of 12 days post‐injury (median 10 days post‐injury, range 2–33 days). Univariate analyses for each metabolite found no statistically significant metabolite differences between groups. Within each analysis, several covariates were statistically significant. Follow‐up analyses designed to account for possible confounding factors including age, site, scanner, vendor, time since injury, and tissue type (and interactions as appropriate) did not find any metabolite group differences. In the largest sample of pediatric concussion studied with MRS to date, we found no metabolite differences between concussion and OI groups in the L‐DLPFC. We suggest that at 2 weeks post‐injury in a general pediatric concussion population, brain metabolites in the L‐DLPFC are not specifically affected by brain injury.

Funder

Alberta Children's Hospital Research Institute

Canada Research Chairs

Canadian Institutes of Health Research

Hotchkiss Brain Institute, University of Calgary

Publisher

Wiley

Subject

Neurology (clinical),Neurology,Radiology, Nuclear Medicine and imaging,Radiological and Ultrasound Technology,Anatomy

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