[Abstract] 89. Prediction of Long-term Neurological and Neuropsychological Effects of Traumatic Brain Injury in Infants and Children using Proton Magnetic Resonance Spectroscopy

The ability to predict long-term neurological and neuropsy-chological outcome in 22 children, aged 1 week to 14 years at the time of traumatic brain injury (TBI) were investigated using proton magnetic resonance spectroscopy (MRS) acquired after injury and compared with standardized neuro-logical, intellectual, and neuropsychological testing per-formed 1 to 7 years later. In 13, injury was caused by motor-vehicle accidents and in 9 by nonaccidental trauma. Clinical indicators of acute injury severity including age at injury,electroencephalogram, MRS variables of N-acetylaspartase/Cho, Cho/Cre, and lactate presence accurately classified children as functioning above or below the average range for most outcome measures. Combined clinical and MRS variables accounted for approximately 50% of the variance in cognitive and neuropsychological outcome confirming the validity of their predictive use. Of the injury severity indictors, presence of lactate is a particularly important prognostic marker of poor long-term intellectual and neuropsychological functioning. Our findings indicate the potential for providing accurate estimates of long-term intellectual and neuropsychological functioning after TBI in infants and children using proton MRS in combination with clinical variables.