Phosphorous magnetic resonance spectroscopy (³¹P-MRS) is suited to noninvasively investigate energy metabolism and to detect molecules containing phosphorus in the human brain. The aim of this longitudinal study was to perform ³¹P-MRS at two different time points (within 72 h and between day 10–14) after severe traumatic brain injury (sTBI) to reveal alterations in cerebral energy metabolism. Twenty-six ventilated patients with sTBI, aged between 20 and 75 years, with a median initial Glasgow Coma Scale score of 5 were analyzed prospectively. The ³¹P-MRS data of the structurally more affected side were compared with data from contralateral normal appearing areas and with data of age- and gender-matched healthy controls. There were no significant intraindividual differences between the lesioned and the less affected side at either of the time points. In the acute phase, phosphocreatine/adenosine triphosphate (PCr/ATP) and phosphocreatine/inorganic phosphate (PCr/Pi) were significantly elevated whereas phosphomonoesters/phosphodiesters (PME/PDE) and Pi/ATP were significantly decreased in contrast to healthy controls. In the subacute phase, these differences gradually dissipated, remaining lower Pi/ATP ratio, and only partly altered levels of PCr/Pi and PME/PDE. Our data affirm that cerebral metabolism is globally altered after sTBI, demonstrating the diffuse impairment of brain bioenergetics at multiple levels, with resultant developments in terms of time.

中文翻译：

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重度外伤性脑损伤中的重复 31P 磁共振光谱：对脑能量状态和代谢改变的见解

磷磁共振波谱 ( ³¹ P-MRS) 适用于无创研究能量代谢和检测人脑中的含磷分子。这项纵向研究的目的是在严重创伤性脑损伤 (sTBI) 后的两个不同时间点（72 小时内和 10-14 天之间）进行^{31 P-MRS，以揭示脑能量代谢的变化。}前瞻性分析了 26 名 sTBI 通气患者，年龄在 20 至 75 岁之间，初始格拉斯哥昏迷评分中位数为 5。³¹ _将结构上受影响的一侧的 P-MRS 数据与对侧正常出现区域的数据以及年龄和性别匹配的健康对照的数据进行比较。在任一时间点，病变侧和受影响较小的一侧之间没有显着的个体内差异。在急性期，与健康对照组相比，磷酸肌酸/三磷酸腺苷 (PCr/ATP) 和磷酸肌酸/无机磷酸盐 (PCr/Pi) 显着升高，而磷酸单酯/磷酸二酯 (PME/PDE) 和 Pi/ATP 显着降低。在亚急性期，这些差异逐渐消失，保持较低的 Pi/ATP 比率，仅部分改变 PCr/Pi 和 PME/PDE 的水平。我们的数据证实脑代谢在 sTBI 后发生了全局性改变，