The clinical utility of proton magnetic resonance spectroscopy in traumatic brain injury: recommendations from the ENIGMA MRS working group

• DOI: 10.1007/s11682-020-00330-6
• Publication Date: 2020-08-14T11:27:00Z
• Authors: Brenda L Bartnik-...; Jeffry R Alger; Talin Babikian; Ashley D Harris; Barbara Holshouser; Ivan I Kirov; Andrew A Maudsley; Paul M Thompson; Emily L Dennis; David F Tate; Elisabeth A Wilde; Alexander Lin
• Keywords: Traumatic; Adult; Physical Injury - Accidents and Adverse Effects; Biomedical and clinical sciences; Magnetic Resonance Spectroscopy; Proton Magnetic Resonance Spectroscopy; Clinical Sciences; Concussion; Traumatic Brain Injury (TBI); Trauma; Medical and Health Sciences; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Magnetic resonance spectroscopy; Brain Injuries, Traumatic; Psychology; Humans; Brain injury; Child; Traumatic Head and Spine Injury; screening and diagnosis; Biomedical and Clinical Sciences; Psychology and Cognitive Sciences; Neurosciences; Health sciences; Brain; Experimental Psychology; Injuries and accidents; Magnetic Resonance Imaging; Brain Disorders; 4.1 Discovery and preclinical testing of markers and technologies; 3. Good health; Detection; Brain Injuries; Neurological; Biomedical Imaging

Proton (1H) magnetic resonance spectroscopy provides a non-invasive and quantitative measure of brain metabolites. Traumatic brain injury impacts cerebral metabolism and a number of research groups have successfully used this technique as a biomarker of injury and/or outcome in both pediatric and adult TBI populations. However, this technique is underutilized, with studies being performed primarily at centers with access to MR research support. In this paper we present a technical introduction to the acquisition and analysis of in vivo 1H magnetic resonance spectroscopy and review 1H magnetic resonance spectroscopy findings in different injury populations. In addition, we propose a basic 1H magnetic resonance spectroscopy data acquisition scheme (Supplemental Information) that can be added to any imaging protocol, regardless of clinical magnetic resonance platform. We outline a number of considerations for study design as a way of encouraging the use of 1H magnetic resonance spectroscopy in the study of traumatic brain injury, as well as recommendations to improve data harmonization across groups already using this technique.