Do NAA/CHO and NAA/CR ratios as measure by 1h MR spectroscopy differ between symptomatic and non-symptomatic concussed athletes in the early post injury period?

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@article{f399f1ec660c4613a379571a0975dca1,
title = "Do NAA/CHO and NAA/CR ratios as measure by 1h MR spectroscopy differ between symptomatic and non-symptomatic concussed athletes in the early post injury period?",
abstract = " Objective Changes in cerebral N-acetylaspartate and choline (NAA/Cho) or creatine (NAA/Cr) following a mild traumatic brain injury (mTBI) in sport have been measured by 1H (Proton) magnetic resonance spectroscopy (1H-MRS). We intend to investigate the effect that presenting symptomatology has on these parameters. Design Observational cohort study. Setting UK Premiership and Championship Rugby. Participants Athletes aged 18-40 years. Interventions (or assessment of risk factors) Concussed athletes identified by members of their enhanced-care clinical team. Imaging undertaken on a Philips Achieva 3.0 T MR scanner (32 channel SENSE coil). A PRESS sequence (et 37 ms, rt 2000 ms) generated spectra in a 20 mm MRS cubic voxel in right-sided superior frontal white matter. Symptoms were assessed using the IMPACT and SCAT-3 concussion assessment tools. Recruits were divided into either {\textquoteleft}symptomatic{\textquoteright} or {\textquoteleft}non-symptomatic{\textquoteright} at presentation based on a minimum severity score from either of these assessments. Outcome measures Analysis of raw parameters was undertaken utilising the TARQUIN 1H-MRS analytical software package. A Mann-Whitney-U test was performed to compare results between the symptomatic and non-symptomatic groups. Main results 33 concussed professional athletes were recruited. Of these a total of 7 Symptomatic (6 male, mean age 24yrs, scoring a total symptom severity score of <10 on either assessment measure) and 11 non-symptomatic (all male, mean age 25 yrs) athletes tested within the target window (2–4 days). Ratios between groups did not vary significantly (NAA/Cho mean 4.43 vs 4.53 and NAA/Cr 1.24 vs 1.26, p=0.84 and p=0.99 respectively). Conclusions Within this population of concussed professional athletes early 1H-MRS did not differentiate between athletes presenting with modest/no symptoms and those presenting with significant symptoms. Competing interests None. ",
author = "Antonio Belli and Davies, {David James} and Zhangjie Su and Conor Bentley and Douglas Hammond and {Di Pietro}, Valentina and Hill, {Lisa Jayne} and Shaun Evans",
year = "2017",
doi = "10.1136/bjsports-2016-097270.10",
language = "English",
volume = "51",
pages = "A4--A5",
journal = "British Journal of Sports Medicine",
issn = "0306-3674",
publisher = "BMJ Publishing Group",

}

RIS

TY - JOUR

T1 - Do NAA/CHO and NAA/CR ratios as measure by 1h MR spectroscopy differ between symptomatic and non-symptomatic concussed athletes in the early post injury period?

AU - Belli, Antonio

AU - Davies, David James

AU - Su, Zhangjie

AU - Bentley, Conor

AU - Hammond, Douglas

AU - Di Pietro, Valentina

AU - Hill, Lisa Jayne

AU - Evans, Shaun

PY - 2017

Y1 - 2017

N2 - Objective Changes in cerebral N-acetylaspartate and choline (NAA/Cho) or creatine (NAA/Cr) following a mild traumatic brain injury (mTBI) in sport have been measured by 1H (Proton) magnetic resonance spectroscopy (1H-MRS). We intend to investigate the effect that presenting symptomatology has on these parameters. Design Observational cohort study. Setting UK Premiership and Championship Rugby. Participants Athletes aged 18-40 years. Interventions (or assessment of risk factors) Concussed athletes identified by members of their enhanced-care clinical team. Imaging undertaken on a Philips Achieva 3.0 T MR scanner (32 channel SENSE coil). A PRESS sequence (et 37 ms, rt 2000 ms) generated spectra in a 20 mm MRS cubic voxel in right-sided superior frontal white matter. Symptoms were assessed using the IMPACT and SCAT-3 concussion assessment tools. Recruits were divided into either ‘symptomatic’ or ‘non-symptomatic’ at presentation based on a minimum severity score from either of these assessments. Outcome measures Analysis of raw parameters was undertaken utilising the TARQUIN 1H-MRS analytical software package. A Mann-Whitney-U test was performed to compare results between the symptomatic and non-symptomatic groups. Main results 33 concussed professional athletes were recruited. Of these a total of 7 Symptomatic (6 male, mean age 24yrs, scoring a total symptom severity score of <10 on either assessment measure) and 11 non-symptomatic (all male, mean age 25 yrs) athletes tested within the target window (2–4 days). Ratios between groups did not vary significantly (NAA/Cho mean 4.43 vs 4.53 and NAA/Cr 1.24 vs 1.26, p=0.84 and p=0.99 respectively). Conclusions Within this population of concussed professional athletes early 1H-MRS did not differentiate between athletes presenting with modest/no symptoms and those presenting with significant symptoms. Competing interests None.

AB - Objective Changes in cerebral N-acetylaspartate and choline (NAA/Cho) or creatine (NAA/Cr) following a mild traumatic brain injury (mTBI) in sport have been measured by 1H (Proton) magnetic resonance spectroscopy (1H-MRS). We intend to investigate the effect that presenting symptomatology has on these parameters. Design Observational cohort study. Setting UK Premiership and Championship Rugby. Participants Athletes aged 18-40 years. Interventions (or assessment of risk factors) Concussed athletes identified by members of their enhanced-care clinical team. Imaging undertaken on a Philips Achieva 3.0 T MR scanner (32 channel SENSE coil). A PRESS sequence (et 37 ms, rt 2000 ms) generated spectra in a 20 mm MRS cubic voxel in right-sided superior frontal white matter. Symptoms were assessed using the IMPACT and SCAT-3 concussion assessment tools. Recruits were divided into either ‘symptomatic’ or ‘non-symptomatic’ at presentation based on a minimum severity score from either of these assessments. Outcome measures Analysis of raw parameters was undertaken utilising the TARQUIN 1H-MRS analytical software package. A Mann-Whitney-U test was performed to compare results between the symptomatic and non-symptomatic groups. Main results 33 concussed professional athletes were recruited. Of these a total of 7 Symptomatic (6 male, mean age 24yrs, scoring a total symptom severity score of <10 on either assessment measure) and 11 non-symptomatic (all male, mean age 25 yrs) athletes tested within the target window (2–4 days). Ratios between groups did not vary significantly (NAA/Cho mean 4.43 vs 4.53 and NAA/Cr 1.24 vs 1.26, p=0.84 and p=0.99 respectively). Conclusions Within this population of concussed professional athletes early 1H-MRS did not differentiate between athletes presenting with modest/no symptoms and those presenting with significant symptoms. Competing interests None.

U2 - 10.1136/bjsports-2016-097270.10

DO - 10.1136/bjsports-2016-097270.10

M3 - Abstract

VL - 51

SP - A4-A5

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

ER -