TY - JOUR AU - Meyer, Erin J. AU - Stout, Jeffrey N. AU - Chung, Ai Wern AU - Grant, P. Ellen AU - Mannix, Rebekah AU - Gagoski, Borjan PY - 2019 M3 - Brief Research Report TI - Longitudinal Changes in Magnetic Resonance Spectroscopy in Pediatric Concussion: A Pilot Study JO - Frontiers in Neurology UR - https://www.frontiersin.org/articles/10.3389/fneur.2019.00556 VL - 10 SN - 1664-2295 N2 - Background: Nearly 20% of US adolescents report at least one lifetime concussion. Pathophysiologic models suggest that traumatic biomechanical forces caused by rotational deceleration lead to shear stress, which triggers a neurometabolic cascade beginning with excitotoxicity and leading to significant energy demands and a period of metabolic crisis for the injured brain. Proton magnetic resonance spectroscopy (1H MRS) offers a means for non-invasive measurement of neurometabolic changes after concussion.Objective: Describe longitudinal changes in metabolites measured in vivo in the brains of adolescent patients with concussion.Methods: We prospectively recruited 9 patients ages 11 to 20 who presented to a pediatric Emergency Department within 24 h of concussion. Patients underwent MRI scanning within 72 h (acute, n = 8), 2 weeks (subacute, n = 7), and at approximately 1 year (chronic, n = 7). Healthy, age and sex-matched controls were recruited and scanned once (n = 9). 1H MRS was used to measure N-acetyl-aspartate, choline, creatine, glutamate + glutamine, and myo-inositol concentrations in six regions of interest: left and right frontal white matter, posterior white matter and thalamus.Results: There was a significant increase in total thalamus glutamate+glutamine/choline at the subacute (p = 0.010) and chronic (p = 0.010) time points, and a significant decrease in total white matter myo-inositol/choline (p = 0.030) at the chronic time point as compared to controls.Conclusion: There are no differences in 1H MRS measurements in the acute concussive period; however, changes in glutamate+glutamine and myo-inositol concentrations detectable by 1H MRS may develop beyond the acute period. ER -