Cited by 122

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Experience of diffusion tensor imaging and 1H spectroscopy for outcome prediction in severe traumatic brain injury: Preliminary results*

Tollard, Eléonore, Galanaud, Damien, Perlbarg, Vincent, Sanchez-Pena, Paola, Le Fur, Yann, Abdennour, Lamine, Cozzone, Patrick, Lehericy, Stéphane, Chiras, Jacques, Puybasset, Louis·2009·Critical Care Medicine

Abstract

Objective The objective of the study is to test whether multimodal magnetic resonance imaging can provide a reliable outcome prediction of the clinical status, focusing on consciousness at 1 year after severe traumatic brain injury (TBI). Design Single center prospective cohort with consecutive inclusions. Setting Critical Care Neurosurgical Unit of a university hospital. Patients Forty-three TBI patients not responding to simple orders after sedation cessation and 15 healthy controls. Interventions A multimodal magnetic resonance imaging combining morphologic sequences, diffusion tensor imaging (DTI), and H proton magnetic resonance spectroscopy (MRS) was performed 24 +/- 11 days after severe TBI. The ability of DTI and MRS to predict 1-year outcome was assessed by linear discriminant analysis (LDA). Robustness of the classification was tested using a bootstrap procedure. Measurements and main results Fractional anisotropy (FA) was computed as the mean of values at discrete brain sites in the infratentorial and supratentorial regions. The N-acetyl aspartate/creatine (NAA/Cr) ratio was measured in the thalamus, lenticular nucleus, insular cortex, occipital periventricular white matter, and pons. After 1 year, 19 (44%) patients had unfavorable outcomes (death, persistent vegetative state, or minimally conscious state) and 24 (56%) favorable outcomes (normal consciousness with or without functional impairments). Analysis of variance was performed to compare FA and NAA/Cr in the…

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Crossref · 10.1097/ccm.0b013e31819cf050

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Citations

Cites

  • Neuroanatomical correlates of brainstem coma

    Parvizi, J. (2003) · Brain · doi:10.1093/brain/awg166 · Cited by 400 · cited 2×

    “Each of the five sites selected by LDA may influence consciousness: the pons and posterior fossa, where the reticular activating system is located; the thalamus, whose reticular and intralaminar nuclei belong to the consciousness pathway (33); the lenticular nuclei, which is near the hypothalamus and basal forebrain;…”
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Metadata

Authors
Tollard, E., Galanaud, D., Perlbarg, V., Sanchez-Pena, P., Le Fur, Y., Abdennour, L., Cozzone, P., Lehericy, S., Chiras, J., & Puybasset, L.
Venue
Critical Care Medicine
Published
2009-04
Volume
37
Issue
4
Pages
1448-1455
ISSN
0090-3493
Cited by
122
References
1
Language
en

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