Magnetic resonance spectroscopy in traumatic brain injury

Introduction Traumatic brain injury (TBI) affects approximately 1.5 million people in the USA annually, is the leading cause of death in patients under the age of 45, and has an annual mortality rate of at least 20 per 100 000.[1-3] The long-term impact of TBI is extreme, and even patients with mild or moderate brain injury suffer lingering effects, including impaired cognitive function and increased medical and social costs.[4] Reliable methods for assessing injury severity and predicting patient outcome soon after injury would improve overall clinical management and evaluation of pharmaceutical interventions. Injury severity is commonly measured using the Glasgow Coma Scale (GCS) or the duration of post-traumatic amnesia (PTA).[5,6] Outcome is assessed using the Glasgow Outcome Score (GOS) or the Disability Rating Scale (DRS).[7,8] Cognitive recovery, which is assessed by more finely grained assessment tools such as neuropsychological or intelligence testing, is also used to quantify outcome from TBI. Existing clinical assessment provides some prediction of general outcome but is inadequate for predicting individual cognitive functioning.