Cerebral Metabolic Dysfunction at the Acute Phase of Traumatic Brain Injury Correlates with Long-Term Tissue Loss.
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State: Public
Version: Final published version
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Serval ID
serval:BIB_708BFD3A38AA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cerebral Metabolic Dysfunction at the Acute Phase of Traumatic Brain Injury Correlates with Long-Term Tissue Loss.
Journal
Journal of neurotrauma
ISSN
1557-9042 (Electronic)
ISSN-L
0897-7151
Publication state
Published
Issued date
03/2023
Peer-reviewed
Oui
Volume
40
Number
5-6
Pages
472-481
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Following traumatic brain injury (TBI), cerebral metabolic dysfunction, characterized by an elevated cerebral microdialysis (CMD) lactate/pyruvate (LP) ratio, is associated with poor outcome. However, the exact pathophysiological mechanisms underlying this association are not entirely established. In this pre-planned analysis of the BIOmarkers of AXonal injury after Traumatic Brain Injury (BIO-AX-TBI) prospective study, we investigated any associations of LP ratio with brain structure volume change rates at 1 year. Fourteen subjects underwent acute-phase (0-96 h post-TBI) CMD monitoring and had longitudinal magnetic resonance imaging (MRI) quantification of brain volume loss between the subacute phase (14 days to 6 weeks) and 1 year after TBI, recalculated as an annual rate. On average, CMD showed an elevated (>25) LP ratio (31 [interquartile range (IQR) 24-34]), indicating acute cerebral metabolic dysfunction. Annualized whole brain and total gray matter (GM) volume change rates were abnormally reduced (-3.2% [-9.3 to -2.2] and -1.9% [-4.4 to 1.7], respectively). Reduced annualized total GM volume correlated significantly with elevated CMD LP ratio (Spearman's ρ = -0.68, p-value = 0.01) and low CMD glucose (ρ = 0.66, p-value = 0.01). After adjusting for age, admission Glasgow Coma Scale (GCS) score and CT Marshall score, CMD LP ratio remained strongly associated with 1-year total GM volume change rate (p < 0.001; multi-variable analysis). No relationship was found between WM volume changes and CMD metabolites. We demonstrate a strong association between acute post-traumatic cerebral metabolic dysfunction and 1-year gray matter atrophy, reinforcing the role of CMD LP ratio as an early biomarker of poor long-term recovery after TBI.
Keywords
Humans, Prospective Studies, Brain Injuries, Traumatic/complications, Brain Injuries, Traumatic/diagnostic imaging, Brain Injuries, Traumatic/metabolism, Brain Diseases, Brain/diagnostic imaging, Brain/metabolism, Glasgow Coma Scale, Biomarkers, brain atrophy, cerebral metabolic dysfunction, cerebral microdialysis, lactate/pyruvate ratio, traumatic brain injury
Pubmed
Web of science
Create date
10/10/2022 14:27
Last modification date
06/08/2024 7:02